HCG Monotherapy, worries and questions

[sashaa]

Hi all,

not sure if this is the proper part of the forum to post so please move accordingly if needed. I am saying sorry in advance for the long post as well, please don't hold it against me.

Over the last 3-4 years(I am 33 years old) I have noticed a steady decline in overall life quality. I have been struggling to keep weight off after multiple successful diets. I would estimate my bf to be in the 20-25% range at the moment. I seem to be gaining weight quite readily during certain periods of life i.e. stress, not working out, etc.

I have recently gotten married and we are trying to conceive. After having no success for a while I decided to visit an urologist who did a series of tests which showed terrible sperm count and other parameters being low as well. After further testing he identified some kind of infection in my prostate and testicles that was treated with antibiotics. Slowly but surely my sperm parameters went back to normal.

It has been a year since then and I am now experiencing a slew of other issues(I have had them for a while but now they are more pronounced)

1. Often losing erections during sex (I am able to get an erection just fine)
2. Decreased enjoyment from sex, lower libido, lower sensitivity etc
3. Poor recovery from working out
4. Bleak outlook on life, less overall enjoyment, poor motivation/dedication
5. Stress is affecting me quite more then it used to

I have gone to urologists multiple times with the above symptoms and gotten various hormonal tests. My total testosterone would come back in the 300s and estradiol in the low 20s. Each doctor would say everything is fine and would inevitably prescribe vitamins, tribulus, etc. None of this seems to have any form of effect on me. My last urologist that I went to seems more progressive and wants me to try HCG for the above mentioned points and to also maintain fertility as that is very important for me right now. Below are my last blood tests

FSH - 5.06 ---------------------- 0.7-11.1 mIU/mL
LH - 3.4 ---------------------- 0.8-7.5 mIU/mL
Prolactin - 181 ---------------------- 53.0 - 360.0 mIU/mL
Total Testosterone - 311 ---------------------- 250-1200 ng/dL
DHEA-S - 242 ---------------------- 80-560 ng/dL
SHGB - 29.9 ---------------------- 10-57 nmol/L
TSH - 1.36 ---------------------- 0.4-4.0 µIU/mL
fT4 - 1.28 ---------------------- 0,69 — 1,7 ng/dL
Estradiol - 21,8 ---------------------- 0,0 — 56,0 pg/mL

The doc said that testosterone is way too low for my age. He prescribed the following treatment in order to alleviate symptoms and preserve fertility. He said he expects my total testosterone to go up to 600-800.

1. 10 shots of 1000 UI HCG eod
2. 30 shots of 1500 UI HCG eod after 1
3. Various vitamins/antioxidants/tribulus
4. After two month to do another panel to check how it progresses

I am almost done with step one... so far

1. Overall I feel better
2. Erections are better
3. A long standing joint pain in my right elbow has subsided significantly
4. Recovery, endurance is up
5. Life is more enjoyable

I have a few worries that I would like to get a second opinion on

1. Am I taking too much HCG?
2. If I decide at one point to stop taking HCG, I am assuming I will have to go through a PCT? Has anyone done this before and what does it entail?
3. Any other thoughts that you could share would be great!

Thanks for reading and appreciate any feedback.

@Nelson Vergel I have to say this is an amazing forum and I am enjoying very much reading through so many articles and threads.

 

[Cataceous]

Did anyone suggest trying low-dose Clomid? Although odds of long-term success with it are not high, it has enough advantages to be worth trying first in some cases. In particular, because your SHBG is normal you are a better candidate than guys with higher values.

As for your questions: 1) I would consider those hCG doses to be on the high side. Low and slow is a safer approach. A feature of hCG is that when the dose gets too high you may actually produce less testosterone than with lower doses. And the risk of estradiol problems is greater with higher doses. 2) Nothing special is required when you stop hCG. hCG is actually used as a first step in PCTs. Clomid may speed things up a little, but no guarantees. 3) Since you're doing well so far on the lower dose maybe ask the doctor if you can stay with it rather than increase...

 

[fifty]

Agree on considering sticking to the 1000 doses until new labs. 50% is a big change.

 

[sashaa]

I have tried(self prescribed) Clomid before for various lengths of time and each time it seemed to have no effect on me - maybe I just never did it long enough? I spoke to the doctor about using Clomid but he said he expects me to get superior results on hCG.

@Cataceous Why do you say "I would consider those hCG doses to be on the high side "? Over the last 2 weeks I have done some reading on dosing for hCG and it seems they vary significantly depending the situation. The studies I was able to read on Home - PubMed - NCBI seems to have people on as low as 125UI twice a week to guys doing 3000UI eod, with some even doing 5000IUs a pop. Honestly any other resources that you could point me to would be much welcomed.

I know the doc asked for new labs in a couple of months but would it be prudent to check at say 3 weeks of use with just the 1000 eod protocol? Would that yield "meaningful" results or is the system just too volatile atm to assert anything?

 

[Cataceous]

According to some research, an hCG dose of 1,000 IU EOD could be right around the point where testosterone declines with higher doses. But there will be variation between individuals, so the risk is that you're above your own optimal point. That's why it's better to start lower and work up slowly.

You would get some useful information from labs after three weeks. The half life of hCG is around 36 hours, so plasma levels will be in a regular pattern. Testosterone production might still be in flux, but you'll still get a good idea of your responsiveness. And it would also be useful to check estradiol, as elevated levels are one of the main reasons why guys can't stick with hCG monotherapy.

 

[sashaa]

@Cataceous Thanks for response, I will be reading that closely.

I took your advice and called the doc and he was pleasantly surprised that I am interested in further exploring the available research. He said the following

1. To get a lab assay tomorrow to check what is going on and what the current response is. Based on that he can recommend if we can continue with the current protocol or if we bump the dose.
2. He said that part of the decision to bump the dose is due to the fact that I hold more fat and in his experience I would need a larger dose then usual - he also recommended I start exercising regularly and losing some bodyfat
3. Another point he raised was that the hCG that is available to us is produced in Russia which might not have the same standards as in the USA and hence larger doses are usually warranted.

I will bump again when my new tests are in.

 

[Vince Carter]

Most every HCG Mono protocol you'll see is much higher dosing than when HCG is used as an adjunct to Testosterone. Key problem with HCG mono as noted is with Estrogen production through that direct stim of the testes.
Though note too in your labs youre Primary Hypogonadal, your problem is the testes, and there's really no amount of stim be it HCG or Clomid that is going to appreciably change your Testosterone prod.

 

[sashaa]

@Vince Carter Sorry for the ignorance but how do the labs show I am Primary Hypogonodal?

In this case the new labs I am trying to do would be even more important as it would show that hCG has no effect on testosterone production?

 

[Cataceous]

LH - 3.4 ---------------------- 0.8-7.5 mIU/mL

This is more suggestive of secondary. Primary is usually near or above the top of the range.

 

[Vince Carter]

That's plenty of LH to have a decent Test production, certainly more than he has; Primary.

 

[Vince]

Your FSH and LH has plenty of room to climb. If HCG does not work, I still would try low dose clomid. 12.5 mg everyday, every other day or twice a week.

 

[sashaa]

Hi, got my new lab results back(had to use a new lab so the ranges are different). The labs were taken 36 hours after the last 1000UI injection

hLH - CLIA 0.22 1,7-8,6 mIU/mL
FSH - CLIA 0.66 1,55-9,74 mIU/mL
Testosterone - CLIA 9.46 1,32-8,13 ng/mL
Free Testosterone - RIA 18.6 8,7-54,7 pg/mL
Estradiol - CLIA 64.69 5,37-65,9 pg/mL
SHBG - RIA 32.02 15-100 pg/mL
DHEA - S - RIA 3.56 0.55-4.90 μg/mL
25(OH) Vitamine D - CLIA 30,5 20-70 ng/ml
Insulin - RIA 4.62 0,93-26,5 μIU/mL
Fasting Sugar 79,2 74-106 mg/dL

I am still feeling good, seems that I am probably carrying a bit more water but that does not bother me too much.

As I suspected I don't think it is warranted for me to go to 1500UIs and stick with 1000UI or do yall think I can reduce it even further? Estrogen has gone up significantly... I don't think this is a sensitive test.

Just seeing the very low LH/FSH levels gives me an enormous anxiety on how will this affect my sperm quality in the future... As I said fertility is of outmost importance atm. Any ideas?

I am also worried about my Vitamin D level... I have started supplementing with 5000IU a day.

Please let me know what you think and as always any advice is greatly appreciated!

 

[SilverSurfer]

From your posts it seems you’re feeling well and doing well. Why don’t you just leave it alone, and enjoy life? Keep doing exactly what you have been doing with the protocol as RXd.

And before you post “I feel great, but I want to see if I can feel even better”, I’d say also take the docs advice and get your bum into the gym 5 - 6 days a week, get your nutrition dialed in, and make sure you’re getting 8 hrs of sleep. These are the things that will make you feel the best, but are also the toughest to do.

Also, if fertility is that important to you, go get your sperm frozen. Now. I’m serious. I wouldn’t be playing around with self-RXing drugs, using HCG, or TRT, if I wanted viable baby batter to cook up some children in the near future.

 

[sashaa]

@SilverSurfer Thanks for the feedback, I am indeed making lifestyle changes to match the rest of effort. I have spoken to the doc and he suggested decreasing the the amount of HCG I am taking, supplement with Vitamin D, and lose belly fat. He said we will re-evaluate in a month or two to see the progress.

Great idea to freeze some sperm, I am going to investigate where I can do this locally.

 

[Cataceous]

I'd agree that if things are going well then stick with it. But if you start having issues then you do have room for a dose reduction. Calculated free testosterone is about 23 ng/dL, with 15 being closer to average. And if you're above your optimal dose then you could even see testosterone increase with less hCG.

 

[sashaa]

After my last check-in with the doc he moved me to a E3D injection of roughly 1400IUs. Here are some updated labs

Total Testosterone 651 250-1200 ng/dl
Free Testosterone 12.1 4.85-19 ng/dl or 1.83% calculated
DHEA-S 228 80-560 mg/dl
SHGB 39.6 10-57 nmol/l
Estradiol 115 0-56 ng/ml
TSH 1.2 0.4-4 miu/ml
Total T4 7.13 4.27 - 10.6 mg/dl
Free T4 1.12 0.69-1.7 ng/dl
Total T3 84.2 70-204 ng/dl
Free T3 3.81 1.69-4.7 pg/ml
IGF1 230 41-246 ng/ml
Total Cholesterol 5.46 nmol/L
HDL 1.11 nmol/L
LDL 3.63 nmol/L
Iron 10.75 12.5-32.2 mmol/L

Some outcomes

1. I have lost a good amount of weight during this month as I cleaned up my diet big time and exercised regularly. Cholesterol is down which seems good but also HDL has gone down by .3 nmol/L
2. Stopped taking the daily 25mg DHEA as it seemed to give me itchy nipples
3. Occasional ED issues have appeared but seem to be transient
4. Morning erections still happening
5. Occasional sleep disruptions
6. Estradiol has gone up significantly
7. Tested iron this time and I seem to be below range, not sure how to interpret this at all

I am seeing the doc tomorrow but subjectively I would like to go back to the initial E2D protocol. I have a feeling that we will talk about starting on an AI which I would like to avoid.

Thoughts?

 

[Cataceous]

...
Estradiol 115 0-56 ng/ml
...

Presumably that's "pg/mL"? Personally I would be uneasy having estradiol this high. Statistically speaking you would not expect to find even one normal guy on the planet at this level. An aromatase inhibitor is not likely to be very effective because a lot of the estradiol production is intratesticular. This is why hCG monotherapy can be a challenge.

 

[sashaa]

@Cataceous correct that is pg/ml I had a typo in there. I concur with your view on the AI and that is why I would like to avoid that.

My thinking, and what I should have done from the start, is reduce the dose and keep the E2D protocol. I hope it is not too late to make this change.

 

[Cataceous]

It shouldn't be too late. The main concern is whether you will have sufficient testosterone at lower hCG doses. If you're lucky you are above your maximum-T dose and going lower will raise T and lower estradiol. Otherwise both will fall.

 

[sashaa]

I am just so surprised that

E2D 1000 IU yields Testosterone 9.46 1,32-8,13 ng/mL; Estradiol - 64.69 5,37-65,9 pg/mL
vs
E3D 1500 IU yields Testosterone 651 250-1200 ng/dl; Estradiol 115 0-56 pg/ml

This is the same amount of HCG with wildly different results. What is driving this? Is this purely on how the HCG is absorbed into the body? Are there other factors I need to consider?