HCG Plus Androgens Other Than Test

[Cataceous]

... This means I’m getting something like 9-10 mg a day of testosterone, which is solidly above the general average of 6-7mg a day for a healthy young male, though I think it’s still within one standard deviation.
...

I expect that's getting to be more like two standard deviations. However, I'd give an allowance of an extra 10-20% to compensate for a lack of diurnal variation. That is, if the average healthy young guy makes 6.5 mg of testosterone daily, then that average free testosterone of 14-15 ng/dL refers to the morning peak. The evening trough could easily be 20-40% lower. If we assume peak testosterone is the important parameter then a guy on TRT using relatively frequent injections of a longer testosterone ester would need to use a little more testosterone to reach the peak value, because it's also close to his average value, given that he has little fluctuation in serum testosterone. In the case of the exactly average guy it means his free testosterone on TRT is 14-15 ng/dL all the time; it doesn't decline as the day goes on. Maintaining the level all day then requires a bit more testosterone than the 6.5 mg per day.

...
@Cataceous would be curious to hear your thoughts here, but if we assume 6.5mg (im assuming that’s the average amount men make a day) of T yields a 14 in FT on labs (the average FT for healthy young males) then I’d guess that 9.5mg would yield a 20 in FT (9.5/6.5 multiplied by 14).

Having argued that free testosterone is proportional to production rate or dose rate, I agree with this logic—subject to the adjustment for lack of serum variation when needed.

 

[Gman86]

Thanks @Gman86

Always appreciate your input.

Yeah my hope is that 350iu 3x a week produces a solid less E2 than 500 2x a week. I feel like it’s very hard to do 500 2x a week without an AI, but I never felt good taking the AI.

Regarding the T dose, I’d rather start low and potentially titrate up. I think that my E2 is the limiting factor for dose so I can avoid an AI. I’d stop once my E2 gets too high perhaps, but I’d imagine it would be at least 30 on 80mg T and 1000iu of HCG.

Also, I’m not sure Id really consider 80mg a low dose, especially with HCG. The 80mg yields on average 8mg a day and I’d imagine HCG yields something like 1-2 mg a day. This means I’m getting something like 9-10 mg a day of testosterone, which is solidly above the general average of 6-7mg a day for a healthy young male, though I think it’s still within one standard deviation.

@Cataceous would be curious to hear your thoughts here, but if we assume 6.5mg (im assuming that’s the average amount men make a day) of T yields a 14 in FT on labs (the average FT for healthy young males) then I’d guess that 9.5mg would yield a 20 in FT (9.5/6.5 multiplied by 14).

Clearly u think things out well and have done ur research. It’s obv to me u have a mind that lends itself well to figuring all this hormone stuff out, and u’ll definitely get there. Just takes time and a lot of individual trial and error

I wouldn’t waste time thinking about what a normal male produces and try to get close to that with exogenous test tho. There’s guys that need 250mg+ of exogenous test per week just to hit close to a 1000 total T level, and then there’s other guys that can hit 1000 with 70mg of exogenous test per week. It doesn’t matter what a normal male makes endogenously, we all metabolize exogenous test differently. But it’s obv smart to start relatively low and titrate up if needed. And that’s a good point in regards to HCG adding to ur total test levels. 1000iu’s of Pregnyl HCG used to add roughly 600 points to my total T levels. Now it adds zero to my total T level. Just don’t get the same response from HCG as I used to for some reason. Definitely something to consider tho, ur definitely spot on about that.

 

[Cataceous]

... There’s guys that need 250mg+ of exogenous test per week just to hit close to a 1000 total T level...

These would be the ones who have driven their SHBG down to single digits and are measuring at a weekly trough. Their free testosterone is going to be ridiculously high, and more so at peak. This dose isn't even close to being physiological.

 

[tareload]

These would be the ones who have driven their SHBG down to single digits and are measuring at a weekly trough. Their free testosterone is going to be ridiculously high, and more so at peak. This dose isn't even close to being physiological.

Great point. This response would be the classic 50 mg/day oxandrolone (< 10 nmol/L SHBG) case. Absurd fT.

 

[tareload]

There’s guys that need 250mg+ of exogenous test per week just to hit close to a 1000 total T level,

Very few ( <2 percentile response) ignoring those under the influence of SHBG altering medications.

 

[Gman86]

I was obv referring to outliers on both ends, but we all fall somewhere inbetween. Nobody metabolizes exogenous test the same. So I just don’t see how using the average amount of test natural males produce as a reference makes sense when calculating exogenous test dosages. But I definitely still think starting at the lowest possible dose to try and alleviate symptoms and titrate up slowly if needed is the best plan of action for anybody trying to get dialed in

 

[tareload]

So I just don’t see how using the average amount of test natural males produce as a reference makes sense when calculating exogenous test dosages.

The reasoning would be that using the mean endogeous production rate would give you an excellent starting estimate for the amount of testosterone ester to inject every week (exogenous source) to target physiologic TT/fT levels. Hence, from the work above you can see that 50-100 mg/week of testosterone ester (cypionate / enanthate, correct for ester fraction of the molecular weight) will put the very vast majority of men in physiologic range.

However, the TT response is clouded by SHBG. On your point above regarding different elimination rates, I understand your confusion. These varying parameters (clearance, volume of distribution, absorption rate) will affect the pharmacokinetics (peak / trough) an individual will experience and set the mean. For fT what we seek is a reasonable estimate for clearance (C), distribution volume (V), and absorption rate constant (ka)...

Fortunately we have good estimates for these apparent parameters (but again confounded with SHBG) when measuring TT:


The very useful concept @Cataceous uses is the limit as we continuously infuse testosterone into the body. Let's also assume the subject is shut down so beta(i) goes to zero.

Tthe second equation above becomes

0 = ka*dose - CL/V * fT [in = out]

or

CL/V * fT = ka*dose

hence fT = V/CL * ka * dose


Free testosterone at steady state (the mean concentration we would calculate if we rigorously measured area under the curve) is entirely dependent on 3 parameters and mean dose.

For related example see here:

For those who are struggling on TRT

I've been thinking about this thread lately. Any theories on why you seem to respond better on 1x week versus daily? I've read a number of accounts from med-high SHBG guys like you who do better on less frequent injections. I think it’s just the simple mechanism of the medication itself and...

www.excelmale.com

I am on the fence whether I have done the reader a disservice doing the mean TT vs weekly dose plots above since SHBG is built in. But since TT is still the routine measurement and there is confusion and inaccuracy with fT I haven't tried to build a separate chart for fT YET .

Nevertheless there is good reason why Xyosted comes in three doses and that fact reflects the math above.

Good point on starting and ending with minimum effective dose strategy @Gman86 . I agree. That begs the question where to start...see above.

 

[JRos895]

I was obv referring to outliers on both ends, but we all fall somewhere inbetween. Nobody metabolizes exogenous test the same. So I just don’t see how using the average amount of test natural males produce as a reference makes sense when calculating exogenous test dosages. But I definitely still think starting at the lowest possible dose to try and alleviate symptoms and titrate up slowly if needed is the best plan of action for anybody trying to get dialed in

I would agree you with @Gman86 if the absorption of rate of injections wasn’t close to 100%, such as how we have the gels which absorb around 10% (Testim e.g. has 50mg of testosterone per gel).

My understanding is that the rate of absorption for injections is close to 100%, right @Cataceous? Though I’ve always wondered what the variability was for absorption.

 

[Cataceous]

...
My understanding is that the rate of absorption for injections is close to 100%, right @Cataceous? ...

That's my understanding as well. I haven't seen a description of any process that would prevent a nontrivial fraction from being absorbed after a successful IM or SC injection.

I was obv referring to outliers on both ends...

250 mg per week shouldn't even be thought of as a TRT dose; it's beyond an outlier.

 

[JRos895]

That's my understanding as well. I haven't seen a description of any process that would prevent a nontrivial fraction from being absorbed after a successful IM or SC injection.


250 mg per week shouldn't even be thought of as a TRT dose; it's beyond an outlier.

It would be interesting to see a study

I expect that's getting to be more like two standard deviations. However, I'd give an allowance of an extra 10-20% to compensate for a lack of diurnal variation. That is, if the average healthy young guy makes 6.5 mg of testosterone daily, then that average free testosterone of 14-15 ng/dL refers to the morning peak. The evening trough could easily be 20-40% lower. If we assume peak testosterone is the important parameter then a guy on TRT using relatively frequent injections of a longer testosterone ester would need to use a little more testosterone to reach the peak value, because it's also close to his average value, given that he has little fluctuation in serum testosterone. In the case of the exactly average guy it means his free testosterone on TRT is 14-15 ng/dL all the time; it doesn't decline as the day goes on. Maintaining the level all day then requires a bit more testosterone than the 6.5 mg per day.

Having argued that free testosterone is proportional to production rate or dose rate, I agree with this logic—subject to the adjustment for lack of serum variation when needed.

Do

I expect that's getting to be more like two standard deviations. However, I'd give an allowance of an extra 10-20% to compensate for a lack of diurnal variation. That is, if the average healthy young guy makes 6.5 mg of testosterone daily, then that average free testosterone of 14-15 ng/dL refers to the morning peak. The evening trough could easily be 20-40% lower. If we assume peak testosterone is the important parameter then a guy on TRT using relatively frequent injections of a longer testosterone ester would need to use a little more testosterone to reach the peak value, because it's also close to his average value, given that he has little fluctuation in serum testosterone. In the case of the exactly average guy it means his free testosterone on TRT is 14-15 ng/dL all the time; it doesn't decline as the day goes on. Maintaining the level all day then requires a bit more testosterone than the 6.5 mg per day.

Having argued that free testosterone is proportional to production rate or dose rate, I agree with this logic—subject to the adjustment for lack of serum variation when needed.

I’ve seen studies that say 14-15ng/dl is the average FT, and I assume you have to.

Do you rem

Clearly u think things out well and have done ur research. It’s obv to me u have a mind that lends itself well to figuring all this hormone stuff out, and u’ll definitely get there. Just takes time and a lot of individual trial and error

I wouldn’t waste time thinking about what a normal male produces and try to get close to that with exogenous test tho. There’s guys that need 250mg+ of exogenous test per week just to hit close to a 1000 total T level, and then there’s other guys that can hit 1000 with 70mg of exogenous test per week. It doesn’t matter what a normal male makes endogenously, we all metabolize exogenous test differently. But it’s obv smart to start relatively low and titrate up if needed. And that’s a good point in regards to HCG adding to ur total test levels. 1000iu’s of Pregnyl HCG used to add roughly 600 points to my total T levels. Now it adds zero to my total T level. Just don’t get the same response from HCG as I used to for some reason. Definitely something to consider tho, ur definitely spot on about that.

Crazy that the HCG now adds zero to your T. Any idea why that might be?

Have you been using the Pregnyl recently?

 

[Gman86]

It would be interesting to see a study

Do

I’ve seen studies that say 14-15ng/dl is the average FT, and I assume you have to.

Do you rem

Crazy that the HCG now adds zero to your T. Any idea why that might be?

Have you been using the Pregnyl recently?

No idea why. It doesn’t increase testicular size for me either anymore. Ya switched to Pregnyl quite a while back now

 

[tareload]

Now it adds zero to my total T level.

How did you come to that conclusion?

 

[Gman86]

How did you come to that conclusion?

I know roughly where my T dose should bring my total T level to off HCG, and saw no difference to that level on Pregnyl currently. Plus when Pregnyl used to increase my total T level pretty substantially my testicles would increase in volume very noticeably, my progesterone level would increase quite a bit, my E2 would go up quite a bit and my DHEA-S level would increase 100-200 points above baseline. Literally none of those things happen anymore on Pregnyl. Which just further reinforces that it’s not increasing my total T level either. In the past HCG either has done all of those things at the same time, or none of those things. I’ve never had an increase in total T with HCG without those other hormones being effected as well

 

[tareload]

I know rightly where my T dose should bring my total T level to off HCG, and saw no difference to that level on Pregnyl currently. Plus when Pregnyl used to increase my total T level pretty substantially my testicles would increase in volume very noticeably, my progesterone level would increase quite a bit, my E2 would go up quite a bit and my DHEA-S level would increase 100-200 points above baseline. Literally none of those things happen anymore on Pregnyl. Which just further reinforces that it’s not increasing my total T level either. In the past HCG either has done all of those things at the same time, or none of those things. I’ve never had an increase in total T with HCG without those other hormones being effected as well

Did you confirm with multiple vials? You mention it has been a while. Thanks.

SHBG same + / - hCG?

Any other protocol changes before and after (AAS wise)?

 

[Cataceous]

It would be interesting to see a study
...

You can get there via a comparison to IM. The Wiki article observes that IM bioavailability can be 95%. In the subcutaneous section below it's noted that this method is "effective and has similar pharmacokinetics to intramuscular injection." In particular, the Xyosted trial researchers noted that their AUC results are "suggesting that the bioavailability of TE is similar whether administered SC or IM."

...
I’ve seen studies that say 14-15ng/dl is the average FT, and I assume you have to.
...

Yes, using the Vermeulen calculation.

 

[FunkOdyssey]

No idea why. It doesn’t increase testicular size for me either anymore. Ya switched to Pregnyl quite a while back now

When hCG stops working like this, and it doesn't seem that uncommon, are you resistant to LH also or just hCG? Wondering if people that burn out on hCG have basically given themselves primary hypogonadism.

 

[Gman86]

Did you confirm with multiple vials? You mention it has been a while. Thanks.

SHBG same + / - hCG?

Any other protocol changes before and after (AAS wise)?

Ya HCG hasn’t worked for me in years. Only thing it does for me is keep me fertile. But there’s no way for me to know if I would be fertile without it. Had my son on HCG, and had a pregnancy scare on hcg not long ago.

But at this point I can tell if HCG is working in all those other ways or not based on whether it increases testicular size or not. HCG hasn’t increased testicular size even a little bit in years. Had labs done a few times while on Pregnyl again recently tho and it didn’t increase any of the hormones that it used to. So other than keeping me fertile it’s like injecting water. Even Pregnyl. But again, I might be fertile without the HCG. Wish I knew why my leydig cells just don’t seem to be responding to HCG anymore. And ya I’ve gone through 2 vials of Pregnyl so far since switching from empower’s HCG

 

[Gman86]

When hCG stops working like this, and it doesn't seem that uncommon, are you resistant to LH also or just hCG? Wondering if people that burn out on hCG have basically given themselves primary hypogonadism.

That’s a great question. I’m very curious if HMG or FSH would increase testicular size still even tho HCG doesn’t seem to do anything anymore in that regard. Do they sell straight LH? I assume so if FSH is available

 

[Fortunate]

Data point: I resumed hCG over last two days, after being mostly off for several months. Feel an immediate change. More optimistic psychologically, more energy throughout day. And, this is from 100IU daily.

On the flip side, I sense a very mild, faint sense of anxiety and have a low grade headache (which is common for me).

 

[JRos895]

It would be interesting to see a study

Do

I’ve seen studies that say 14-15ng/dl is the average FT, and I assume you have to.

Do you rem

Crazy that the HCG now adds zero to your T. Any idea why that might be?

Have you been using the Pregnyl this whole time?

That’s a great question. I’m very curious if HMG or FSH would increase testicular size still even tho HCG doesn’t seem to do anything anymore in that regard. Do they sell straight LH? I assume so if FSH is available

It doesn’t even seem like you used such large doses of HCG though, which is what is generally concerning.

Though I wonder if you’re lack of response is due to too much HCG, or not enough.