Low T and elevated fasting blood sugar

CSI007 · Mar 19, 2016

Hello everyone,

I have been dealing with low T for a couple of years if not more (I am 45) and recently found a really good doctor to treat me.

We have tried clomid but I quickly began to have vision issues (pain and some blurred vision) at a very low 25mg once every 3 days. So I had to forget about that.

Anyway, I started on HCG monotherapy two weeks ago and today is my 5th injection (500iu twice per week).

I feel like it has started to have an impact on the various issues I have been having.

So back to the title of the thread. Two years ago my previous GP told me to cut down on carbs because I had elevated blood sugar (126 fasting) at the time. So I decided to change my eating habits and went low carb. I lost 40lbs and for the most part have kept it off until I had the low T crisis.

I monitor every day and my fasting blood glucose is generally 100 to 125. Mostly lower end. I feel like the problem is defiantly related to the low T situation and also my now diagnosed hypothyroidism - which I am also dealing with)

Once I can get this low T and extremely low estrogen in check how soon should I see improvement in my fasting blood sugar?

Thanks for the help!

Vince · Mar 19, 2016

I apologize I'm using my phone. Welcome to excelmale. It took me about a year. My fasting glucose is now 67 and my ac-1 is now 5.2. I believe testosterone really helped my glucose numbers

CSI007 · Mar 19, 2016

Hello Vince,
Thanks for the response! What kind of values did you have before you started raising your T levels? Have you had to treat with something else like metformin?

About a month ago my A1C was 5.9 Two years ago it was 6.0 but it took me two years of low carb to barely move it.

Besides what I mentioned above I am also taking 2 1 Body thyroid supplements per day, daily vitamin gummies (I know!) 600MG of Alpha lipoic acid, and 10000iu of vitamin D3.

Vince · Mar 20, 2016

CS, I use 750mg metformin ER twice a day, it is a very benign drug as long as your b vitamins are good. I'm told on average a type 2 diabetic out lives someone who's not diabetic and does not use metformin. https://www.sciencedaily.com/releases/2014/08/140807215552.htm

GA8314 · Mar 20, 2016

Vince said:
CS, I use 750mg metformin ER twice a day, it is a very benign drug as long as your b vitamins are good. I'm told on average a type 2 diabetic out lives someone who's not diabetic and does not use metformin. https://www.sciencedaily.com/releases/2014/08/140807215552.htm

I max out metformin totaling 2500mg/day. It has helped me immensely. I was heading towards clinical pre diabetes and knew I had to do something. It's helped a lot. I think it's also allowed me to lose weight easier (it's never easy) and to keep it off. I no longer feel so discouraged about my carb intolerance (another way of saying insulin resistance).

CSI007 · Mar 20, 2016

Thanks guys for the info. I have been hesitant to get on metformin because I figured my problem is related to my low T and thyroid (and my diet of eating (mostly drinking) over 500grams of carbs per day) and I was hoping it would resolve itself before I needed to add additional medication.

Up until all this crap with my low testosterone started I only took a daily vitamin each day. Rarely did I take any medication at all.

My T was at 326 (range starts at 329) shortly after stopping the clomid. The lowest I ever measured was 280 something. Free T has been generally below normal levels as well. I sure hope that the HCG helps me get back to my old self (ED resolution mainly now since my mood, spirits and energy are getting very good again after years of feeling like crap!)

Re-Ride · Mar 21, 2016

You are obliged to follow your doc. It's great that you found one who will prescribe hCG. I don't see how 500 IU twice weekly or even MWF will work as a mono therapy. Consider a consult from Defy and share that with your doc. Given your situation it will be worthwhile to get at least total T at 48 hrs 72 hrs and 96 hrs to demonstrate to yourself and your doc what I wrote in your other thread.

Most on here are doing hCG for testicular maintenance. They can get by with 2 or 3x per week dosing. We can't. As for your other issues I'm not so sure radical low carbs is the way to go. I got my trigs, cholesterol and blood sugar in to a healthy range by focusing on whole fresh food. Energy increased considerably with the addition of the appropriate aminos herbs and minerals In my case at least this proved superior to the sports drinks. It is likely that a multi-vitamin is insufficient. Better to split out the B's and supplement with exactly what you need and how often you need them which can be two or three times a day during recovery.

CSI007 · Mar 21, 2016

Thank you for the info. I will follow the Doctors recommendations for now but based on my research I would tend to agree with you. I think it may be a good idea to see what my T looks like right before the next injection and then right after it to see how it varies.

Are you using mono-therapy? There does not seem to be a whole lot of information anywhere regards to this. I have been all over the web looking. Though there appears to be some success.

Two years ago almost to the month I had blood work done and that is when I had a FBG of 126 and an A1C of 6.0 I am overweight and have been for most of my life so my Dr told me to reduce the carbs so that was why I went to low carbs. I didn't eat many sugar laden foods but I used to drink a TON of fruit juices. I probably consumed 300 to 500 carbs some days in fruit juice!

Before this we ate mostly organic fruits, veggies and meats/dairy.

I have not posted any of my history here but here are some details from a post I made on another forum.

I just turned 45. I have been married to a beautiful and wonderful wife for 18 years.

16 years ago I was diagnosed with Hodgkins Lymphoma. I went through 6 cycles of ABVD (6 months, twice per month). Remission soon after treatments began. I had bleomycin toxicity mid way through treatments and it was stopped. Also have some peripheral neurapathy from the vinblastine.

I dealt with panic attacks shortly after my treatment ended. They were quite severe at times and I was placed on Paxil which helped...for a time. Then I started to have sexual side effects and after about 6 to 8 months on Paxil I weened myself off and started taking a natural alternative which worked well for years until I also got myself off of it.

Had been fine for a couple years but as time has gone on I could feel my sex drive reducing. I figured this was the stress of life. Recently lost many family members including my Dad who died suddenly. Each major event seemed to have a little more impact on the sexual department.

About two years ago. I started to occasionally have issues with erections. They would be softer. I have never really had issues with endurance etc. Not every time and it seemed to be only occasionally. My ejaculate (the sperm) seems much thicker and gelatinous. My climaxes have changed too. Some times they just don't feel right. Not a powerful, and some times it's near impossible to climax. This past year it seems to be getting worse though so I decided it was time to see a doctor about it. I suspected low-t. I went to a urologist and discussed with him the above. I had blood work done and it came back 328 (300 to ... normal) The pituitary tests all came back normal so he doesn't suspect issues with that end of things. He now wants
me to use natesto 3 times per day for about a month and then have another check up.

Also, Last year I had a check up and my blood glucose was slightly elevated and my A1C was also slightly elevated. I decided I should cut back on the carbs (I ate about 400 to 500 per day - mostly juice) I went on low carb February of 2014 and within a few months lost over 40lbs. To this day I continue low carb ( I typically eat about 20 to 30 carbs per day or even less) but I have hit a brick wall and pretty much nothing I do can break through it. I wanted to lose another 15 to 20lbs before I was satisfied with my weight loss. My A1C has not budged and my fasting BG, while it has not returned to normal has lowered some. I check my blood on a regular basis and I do not believe that I am a full blown diabetic. Most readings after eating quickly fall to normal levels.

So, the reason why I am posting this. I talked with the Doc last night about this. I am not sure that I want to do the testosterone replacement route just yet. Maybe some more testing since I have only had a single test and it was low (tested at 8:45am) Also, while I am pretty sure that my condition with regards to low-t is from the chemotherapy...Perhaps there is another reason?

Also, I believe my main issues are with ED, penis sensitivity and maintaining erections. But lately I have been having lots of short term memory problems etc. And for years I have not been as sharp as I used to be mentally. I feel like I am in a fog mentally. But I figured this was because of the chemo. But maybe it isn't maybe it's been the test slowly decreasing and getting worse? Or perhaps all of the above is also because of the use of the Paxil. I have heard that long term effects are similar to what I am experiencing sexually.

Quite frankly, I have never been one to take medicine. I rarely drink. And reading the side effects of the test replacement scare the hell out of me. LOL I figure once you get on this train you are on it for the long haul. Certainly not something to take lightly and should be thought about carefully.

(Sorry about the formatting below!!!)

Late November, 2015

testosterone , serum 328 348-1197 ng/dL
lh 2.4 1.7-8.6 mIU/mL
fsh 2.6 1.5-12.4 mIU/mL

prostate specific ag, serum 0.5 0.0-4.0 ng/mL

The Prolacin is 15.2 The range is 4 to 15.2
The Estradiol was 9.1 The normal range is 7.6-42.6

Janurary 2016
Thyroid Function.

triiodothyronine, free, serum
2.9 pg/mL 2.0-4.4 completed Not applicable 01/10/2016

thyroxine, serum, free
1.19 ng/dL 0.82-1.77 completed Not applicable 01/10/2016

thyroid stimulating hormone, serum
4.470 u[iU]/mL 0.450-4.500 completed Not applicable

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]hemoglobin a1c[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]5.9[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]4.8-5.6[/TD]
[TD="class: alternatingRow ccrItemText"]%[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]lh[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]4.2[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]1.7-8.6[/TD]
[TD="class: alternatingRow ccrItemText"]mIU/mL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]prolactin[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]10.6[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]4.0-15.2[/TD]
[TD="class: alternatingRow ccrItemText"] ng/mL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]estosterone, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]289[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]348-1197[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]free testosterone(direct)[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]5.8[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]6.8-21.5[/TD]
[TD="class: alternatingRow ccrItemText"]pg/mL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]glucose, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]104[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]65-99[/TD]
[TD="class: alternatingRow ccrItemText"][/TD]
[/TR]
[/TABLE]

Feb 4, 2016

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]vitamin b12[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]762[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]211-946[/TD]
[TD="class: alternatingRow ccrItemText"]pg/mL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]t4,free(direct)[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]1.11[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.82-1.77[/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]dhea-sulfate[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]180.5[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]71.6-375.4[/TD]
[TD="class: alternatingRow ccrItemText"]ug/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]Reverse t3, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]16.0[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]9.2-24.1[/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]vitamin d, 25-hydroxy[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]28.1[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]30.0-100.0[/TD]
[TD="class: alternatingRow ccrItemText"]ng/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]thyroglobulin antibody[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]1.1[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.0-0.9[/TD]
[TD="class: alternatingRow ccrItemText"]IU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]estrogens, total[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]110[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]40-115[/TD]
[TD="class: alternatingRow ccrItemText"]pg/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]ferritin, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]480[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]30-400[/TD]
[TD="class: alternatingRow ccrItemText"]ng/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]thyroid peroxidase (tpo) ab[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]38[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0-34[/TD]
[TD="class: alternatingRow ccrItemText"]IU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]glucose, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]115[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]65-99[/TD]
[TD="class: alternatingRow ccrItemText"]mg/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]pregnenolone, ms[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]20[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]prostate specific ag, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.7[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.0-4.0[/TD]
[TD="class: alternatingRow ccrItemText"]ng/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]dihydrotestosterone[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]28[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]cortisol[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]18.6[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]See Comments[/TD]
[TD="class: alternatingRow ccrItemText"]ug/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]tsh[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]3.390[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.450-4.500[/TD]
[TD="class: alternatingRow ccrItemText"]uIU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]insulin[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]11.3[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]2.6-24.9[/TD]
[TD="class: alternatingRow ccrItemText"]uIU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]testosterone, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]327[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]348-1197[/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]testosterone,free[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]7.72[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]5.00-21.00[/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]lh[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]2.3[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]1.7-8.6[/TD]
[TD="class: alternatingRow ccrItemText"]mIU/mL[/TD]
[/TR]
[TR]
[TD="class: ccrItemText"]fsh[/TD]
[TD="class: LabCorpCCRItemText"][/TD]
[TD="class: LabCorpCCRItemText"]3.4[/TD]
[TD="class: LabCorpCCRItemText"][/TD]
[TD="class: LabCorpCCRItemText"]1.5-12.4[/TD]
[TD="class: ccrItemText"]mIU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]prolactin[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]7.8[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]4.0-15.2[/TD]
[TD="class: alternatingRow ccrItemText"]ng/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]estradiol[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]16.1[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]7.6-42.6[/TD]
[TD="class: alternatingRow ccrItemText"]pg/mL[/TD]
[/TR]
[/TABLE]

GA8314 · Mar 21, 2016

CSI007 said:
Thank you for the info. I will follow the Doctors recommendations for now but based on my research I would tend to agree with you. I think it may be a good idea to see what my T looks like right before the next injection and then right after it to see how it varies.

Are you using mono-therapy? There does not seem to be a whole lot of information anywhere regards to this. I have been all over the web looking. Though there appears to be some success.

Two years ago almost to the month I had blood work done and that is when I had a FBG of 126 and an A1C of 6.0 I am overweight and have been for most of my life so my Dr told me to reduce the carbs so that was why I went to low carbs. I didn't eat many sugar laden foods but I used to drink a TON of fruit juices. I probably consumed 300 to 500 carbs some days in fruit juice!

Before this we ate mostly organic fruits, veggies and meats/dairy.

I have not posted any of my history here but here are some details from a post I made on another forum.

I just turned 45. I have been married to a beautiful and wonderful wife for 18 years.

16 years ago I was diagnosed with Hodgkins Lymphoma. I went through 6 cycles of ABVD (6 months, twice per month). Remission soon after treatments began. I had bleomycin toxicity mid way through treatments and it was stopped. Also have some peripheral neurapathy from the vinblastine.

I dealt with panic attacks shortly after my treatment ended. They were quite severe at times and I was placed on Paxil which helped...for a time. Then I started to have sexual side effects and after about 6 to 8 months on Paxil I weened myself off and started taking a natural alternative which worked well for years until I also got myself off of it.

Had been fine for a couple years but as time has gone on I could feel my sex drive reducing. I figured this was the stress of life. Recently lost many family members including my Dad who died suddenly. Each major event seemed to have a little more impact on the sexual department.

About two years ago. I started to occasionally have issues with erections. They would be softer. I have never really had issues with endurance etc. Not every time and it seemed to be only occasionally. My ejaculate (the sperm) seems much thicker and gelatinous. My climaxes have changed too. Some times they just don't feel right. Not a powerful, and some times it's near impossible to climax. This past year it seems to be getting worse though so I decided it was time to see a doctor about it. I suspected low-t. I went to a urologist and discussed with him the above. I had blood work done and it came back 328 (300 to ... normal) The pituitary tests all came back normal so he doesn't suspect issues with that end of things. He now wants
me to use natesto 3 times per day for about a month and then have another check up.

Also, Last year I had a check up and my blood glucose was slightly elevated and my A1C was also slightly elevated. I decided I should cut back on the carbs (I ate about 400 to 500 per day - mostly juice) I went on low carb February of 2014 and within a few months lost over 40lbs. To this day I continue low carb ( I typically eat about 20 to 30 carbs per day or even less) but I have hit a brick wall and pretty much nothing I do can break through it. I wanted to lose another 15 to 20lbs before I was satisfied with my weight loss. My A1C has not budged and my fasting BG, while it has not returned to normal has lowered some. I check my blood on a regular basis and I do not believe that I am a full blown diabetic. Most readings after eating quickly fall to normal levels.

So, the reason why I am posting this. I talked with the Doc last night about this. I am not sure that I want to do the testosterone replacement route just yet. Maybe some more testing since I have only had a single test and it was low (tested at 8:45am) Also, while I am pretty sure that my condition with regards to low-t is from the chemotherapy...Perhaps there is another reason?

Also, I believe my main issues are with ED, penis sensitivity and maintaining erections. But lately I have been having lots of short term memory problems etc. And for years I have not been as sharp as I used to be mentally. I feel like I am in a fog mentally. But I figured this was because of the chemo. But maybe it isn't maybe it's been the test slowly decreasing and getting worse? Or perhaps all of the above is also because of the use of the Paxil. I have heard that long term effects are similar to what I am experiencing sexually.

Quite frankly, I have never been one to take medicine. I rarely drink. And reading the side effects of the test replacement scare the hell out of me. LOL I figure once you get on this train you are on it for the long haul. Certainly not something to take lightly and should be thought about carefully.

(Sorry about the formatting below!!!)

Late November, 2015

testosterone , serum 328 348-1197 ng/dL
lh 2.4 1.7-8.6 mIU/mL
fsh 2.6 1.5-12.4 mIU/mL

prostate specific ag, serum 0.5 0.0-4.0 ng/mL

The Prolacin is 15.2 The range is 4 to 15.2
The Estradiol was 9.1 The normal range is 7.6-42.6

Janurary 2016
Thyroid Function.

triiodothyronine, free, serum
2.9 pg/mL 2.0-4.4 completed Not applicable 01/10/2016

thyroxine, serum, free
1.19 ng/dL 0.82-1.77 completed Not applicable 01/10/2016

thyroid stimulating hormone, serum
4.470 u[iU]/mL 0.450-4.500 completed Not applicable

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]hemoglobin a1c[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]5.9[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]4.8-5.6[/TD]
[TD="class: alternatingRow ccrItemText"]%[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]lh[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]4.2[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]1.7-8.6[/TD]
[TD="class: alternatingRow ccrItemText"]mIU/mL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]prolactin[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]10.6[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]4.0-15.2[/TD]
[TD="class: alternatingRow ccrItemText"] ng/mL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]estosterone, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]289[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]348-1197[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]free testosterone(direct)[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]5.8[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]6.8-21.5[/TD]
[TD="class: alternatingRow ccrItemText"]pg/mL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]glucose, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]104[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]65-99[/TD]
[TD="class: alternatingRow ccrItemText"][/TD]
[/TR]
[/TABLE]

Feb 4, 2016

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]vitamin b12[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]762[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]211-946[/TD]
[TD="class: alternatingRow ccrItemText"]pg/mL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]t4,free(direct)[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]1.11[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.82-1.77[/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]
[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]dhea-sulfate[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]180.5[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]71.6-375.4[/TD]
[TD="class: alternatingRow ccrItemText"]ug/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]Reverse t3, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]16.0[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]9.2-24.1[/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]vitamin d, 25-hydroxy[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]28.1[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]30.0-100.0[/TD]
[TD="class: alternatingRow ccrItemText"]ng/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]thyroglobulin antibody[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]1.1[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.0-0.9[/TD]
[TD="class: alternatingRow ccrItemText"]IU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]estrogens, total[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]110[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]40-115[/TD]
[TD="class: alternatingRow ccrItemText"]pg/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]ferritin, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]480[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]30-400[/TD]
[TD="class: alternatingRow ccrItemText"]ng/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]thyroid peroxidase (tpo) ab[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]38[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0-34[/TD]
[TD="class: alternatingRow ccrItemText"]IU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]glucose, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]115[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]65-99[/TD]
[TD="class: alternatingRow ccrItemText"]mg/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]pregnenolone, ms[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]20[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]prostate specific ag, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.7[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.0-4.0[/TD]
[TD="class: alternatingRow ccrItemText"]ng/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]dihydrotestosterone[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]28[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]cortisol[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]18.6[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]See Comments[/TD]
[TD="class: alternatingRow ccrItemText"]ug/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]tsh[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]3.390[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]0.450-4.500[/TD]
[TD="class: alternatingRow ccrItemText"]uIU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]insulin[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]11.3[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]2.6-24.9[/TD]
[TD="class: alternatingRow ccrItemText"]uIU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]testosterone, serum[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]327[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]348-1197[/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]testosterone,free[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]7.72[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]5.00-21.00[/TD]
[TD="class: alternatingRow ccrItemText"]ng/dL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]lh[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]2.3[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]1.7-8.6[/TD]
[TD="class: alternatingRow ccrItemText"]mIU/mL[/TD]
[/TR]
[TR]
[TD="class: ccrItemText"]fsh[/TD]
[TD="class: LabCorpCCRItemText"][/TD]
[TD="class: LabCorpCCRItemText"]3.4[/TD]
[TD="class: LabCorpCCRItemText"][/TD]
[TD="class: LabCorpCCRItemText"]1.5-12.4[/TD]
[TD="class: ccrItemText"]mIU/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]prolactin[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]7.8[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]4.0-15.2[/TD]
[TD="class: alternatingRow ccrItemText"]ng/mL[/TD]
[/TR]
[/TABLE]

[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"]estradiol[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]16.1[/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"]7.6-42.6[/TD]
[TD="class: alternatingRow ccrItemText"]pg/mL[/TD]
[/TR]
[/TABLE]

I'm really sorry to hear everything you've been through. Your history is very complicated. But, your TT is very low, you are 45, and while it's true that you have every other reason to feel non-optimal, I think you need to see a physician specializing in HRT/TRT. It's not going to be a sexual silver bullet as the vincristine induced neuropathy may have done a number on you, but I really have to believe you will benefit from hormonal optimization. I can't think of a drawback from your perspective.

This is something which you need to sit down with someone and discuss, at some length.

I wish you all the best.

CSI007 · Mar 21, 2016

Thank you for your concern.

Actually I am now seeing a natural-path Dr who specializes in HRT.

Re-Ride · Mar 22, 2016

CSI007 said:
...
Are you using mono-therapy? There does not seem to be a whole lot of information anywhere regards to this. I have been all over the web looking. Though there appears to be some success.[TABLE="class: c650 CCRLabResultSubtable"]
[TR]
[TD="class: alternatingRow ccrItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow LabCorpCCRItemText"][/TD]
[TD="class: alternatingRow ccrItemText"][/TD]
[/TR]
[/TABLE]
....

Yes I am on hCG mono. I started on it more than 25 years ago. Like you my hypo-G was brought on by an underlying condition and meds. In that era hCG therapy succumbed to fear and widespread disapproval as a result of so few studies being available in the 80's and 90's. For this reason and because Big Pharma began reaping a gold mine with new patches and gels O was dumped on patches then gel.

I remained in gell hell until about a year ago. The recent resurgence in hCG therapy could not have come at a better time for me. For decades I received virtually no management of my endocrine system by my docs. By last spring I was in a dire state. As is typical low T symptoms were never idetified and I was prescribed anti-anxiety agents and ant-deprssents for them.

I suspect the reason we do not hear more about hCG mono is the almost universal lack of understanding regarding dosing required for hCG's extremely short half life. Endogenous serum T, unlike cyp will crash within -HOURS- in absence of the hCG signal. I have seen my serum T crash from 725 to ~100 in just three days off hCG. This is because LH and FSH production usually ceases while on hCG just as it does on TRT. Endogenous T only lasts hours not days like exogenous T cyp.

Aside from not doing the correct dosing, which is small amounts preferably daily, the other obstacle is excessive intratesticular E2 production. I do believe there are as yet poorly understood mechanisms of adaptation to hCG which can take place. After sticking with hCG mono through an unpleasant resurgence of gyno and other challenges lasting months I seem to have conquered E2 and now requiring very little AI.

It's easy to understand why most men end up on exogenous T cyp or gel. Guys like you and me are then left reading about their very low occasional doses of hCG used to maintain spermatogenisis and worrying that we need to follow their protocols. Those who do will certainly FAIL hCG mono imo.

I am not a doctor. Nothing I am saying here should be construed as advice. I can only share my experience with you. Exceedingly few doctors have the skills, experience and patience required to effectively trreat with hCG mono. You will need to engage someone like Dr. Saya AND you will need to aggressively supplement with the correct aminos and herbs to alleviate the symptoms caused by your underlying health issues and damage from prior prescription drugs much like long term survivors of HIV have done.

No one can predict how well you will do on hCG mono just like no one can predict what TRT might do for you. I do believe, given your relative youth and a baseline of 325, that there is at least a chance that you can recover to a natural state of 600 or better in time freeing you of the need for either TRT or hCG.

It is important to understand that the option to return to NON-hCG stimulated endogenous production, slim as it may be, will almost certainly evaporate once you progress to TRT. It may also dissapear if on hCG mono long enough.

Most, opt out for the comparatively faster results often obtained on TRT in the hope of quickly alleviating symptoms and building mass and not giving mono a chance. This is a difficult decision. No outcome can be guaranteed on either approach.

Key to understanding what you are doing at the moment is that you are very likely shutting down your LH FSH and making your body totally dependent on the hCG signal to produce all of your endogenous T. If that signal is not strong enough or consistent enough you will not have adequate T for health. Your T can then crash lower than your 325 baseline.

The fist step in pursuing hCG mono is establishing what your testes are capable of. This appears to be where you are at now. The product is labeled for dosing and frequency known to accomplish that in those with healthy testes. This is likely higher a dose than required but allows the pt to sort of get by on the MWF dosing (1500 IU 3x week). A more progressive doc will likely choose much lower daily or EOD dosing as above mentioned.

Once it is determined that the man is capable of endogenous production >600 ( an arbitrary number- some men will feel well at 500-700 while others do not ), it is time to determine his unique minimum dose to maintain that level. Typically he will find a unique dose above which he gets no further benefit. That could be 350 EOD or 500 to 800 or more per day in a few cases. This pt dependent highly variable dosing which requires patience and more testing than TRT discourages many docs and pt's from sticking with hCG mono. Read the above as merely my theory or what worked for me.

As C.W. states you have a complex treatment ahead that requires a lot of thought and discussion. Where you are at the moment is on the verge of being forced to decide whether you are ready for lifetime TRT, possibly combined with testicular maintenance dosing of hCG, or you would like to first try proper hCG mono under the care of a specialist and leave your options open.

The good thing is that you seem commited to doing the extra labs required. It is always possible that you will fall outside the bell curve and get an acceptable result at the unusally low dose (for mono) of 500 IU 2 or three times weekly. As long as you test the trough ( longest number of hours after last dose) and establish what your minium serum T is you will be fine.

The above isn't meant to be any sort of guide to hCG mono. Expect a roller coaster ride albeit one that is often not as dramatic as TRT can be.

CSI007 · Mar 22, 2016

Thanks for the very detailed history. Lots of great info I can use going forward for sure.

Right now my concern about testing is when (from my other thread). I want to know if this therapy IS working or not. If it's not doing much good (if any) then I would obviously stop or begin to supplement exogenous T.

When I first started this, I was certainly hoping to be able to "correct" what is going on without the need for pharmaceuticals. But I feel as time goes on I may be dealing with more and more problems (from low T, elevated BG, I think my T has been low for some time and so has my E2 - Over the past 15 years I have developed significant floaters in both eyes with no real reason for this to be occurring) and want to get things moving in the right direction. And of course, my wife has been very understanding but I am sure that all of the other "sudden" ED problems that have occurred in the past 6 to 8 months are weighing heavy on her as well. Earlier last year, the Ed issue was like once a month I would have a soft erection and that manifested into beginning to lose some feeling and strange feeling orgasms and then by late last year full blown ED where I can rarely get and keep and erection. I am at the point now that if I need to be on a life time therapy I will do it BUT if there is still some hope that this can be corrected I will certainly want to give that a try first!

Since I began using the thyroid supplements I have seen some improvements in my well being, energy level, brain fog lifted mostly and the typical hypothyroid issues like constipation (It was terrible for a long time - I attributed it to the LC diet but it was going on well before I started it) I think the introduction of the cytomel (T3) has probably helped a little more and with the introduction of the HCG my energy levels have crept up even a little further. I can tell you I was turning into a couch potato - falling asleep in the mid afternoon or even right after dinner etc. That is not who I was.

In the ED department. I never really had issues with morning wood even through all of this crap the past few months. But as the day progresses things get worse down there. Since I started the HCG, I do note that my libido has increased a little bit. One day last week though right after a shot it was insane! It lasted through the next day then faded. Since then I have taken another shot and did not notice that kind of affect again.

I was thinking that maybe I injected into a blood vessel or something. My semen appears to be thinning out but my erection hardness is still not there and keeping them is still a struggle. From what I read, this can take weeks to months to correct itself - What has been your experience (if you had these same kinds of issues)? Orgasms are starting to feel more normal once again which is good news it just takes so long to reach it. After 2 or 3 minutes of sex the initial sensations of pleasure begin to disappear because of the sensation loss.

Thank you again for taking the time to share your experience with me.

CSI007 · Mar 22, 2016

One other thing I forgot to mention. About 5 years ago I started noticing the hair on the outside of my shins began to fade away. I had pretty hairy legs. The inside hair remained but smooth skin on the outside. Well as time went on it would grow back partially and then disappear again. It seemed to happen in cycles. Since I started treatments (thyroid/HCG) the hair is now growing back again. Maybe a bit fuller but it's only been about a week or so. I first felt stubble about 1 1/2 weeks ago.

I have read all kinds of stuff about the cause of this but I don't think anyone has a real grasp on what causes it in middle aged men (and beyond). I am pretty certain it's androgen in nature. I hope that the fact it's coming back more now is a good indicator that my T is coming up.

I have decided that next Thursday I will get my blood drawn. This will be 3 weeks and 5 days since I started the HCG and two days before the next shot. Hopefully I will see some good results or at least get some more answers.

Re-Ride · Mar 22, 2016

I wish I was qualified to share something of value regarding your metabolic and ED concerns. Finances and insurance have to be considered when choosing one therapy over another. They also affect our diet and choice of supplements.

How easy is it for you to get to early am blood draws?

How many hours will have past since your last hCG shot if you test as planned and how many IU in the preceeding 7 days?

Is it possible for you to do test, at least one time, 24, 48 an 72 hours?

If you test as planned and come back low T as I expect are you and your doc willing to try one of the higher dosing protocols listed on the insert or an alternate higher frequency dosing at your current level of 500 IU ?

What brand of hCG are you taking? Sub Q or IM? Time of day for injection? Are you constant?

You mentioned being on Paxil. Are you still taking this? Any plan to address ED should include a plan to terminate all anti-depressants and anti-anxiety agents if possible. There are some pretty strong testimonials in Gene's NO thread. You might find herbs and supplements to be equally or more effective for boosting mood and cognition. hCG is known to help here too. You haven't failed on hCG or supplements until you've reached an effective dose. With aminos that requires more than popping a few pills at breakfast.

Our age and health issues are significantly divergent that the relevancy of my protocol to you is questionable. At best I can ease your mind over concerns on increasing hCG dosing to effective monotherapy levels. This is a fairly benign substance which is naturally occurring in men. It clears from your body quite fast. Like TRT it requires adherence and being consistent. Introducing multiple variables or altering doses in any two week period will prevent you from dialing in the correct protocol.

If you and doc decide to increase hCG before jumping on te TRT bandwagon you should have anastrozole on hand. 1/4 to 1/2 twice a week are typical IF you approach 30 on the E2 sensitive test. Whatever you do don't go crashing your E2 with too much AI which is all too common a problem.

CSI007 · Mar 22, 2016

I always get my blood drawn between 7:30am and 9am The lab I get the draw from is always packed so even if I get there early I have to wait. But all my testing has been done fasting and early in the morning.

If I draw blood on Thursday of next week it will be about 24 hours after 500iu are administered and it will be 1000iu in the past 7 days.

I will discuss with my Dr about testing over a 72 hour period. I have no objections and I am sure he wouldn't either. My insurance on the other hand. Not sure how they look at blood work. They have paid what is reasonable and customary so far and I pick up the rest of the tab.

If the T comes back low I will certainly consider all options. As I said before, I really don't want to do T unless I have to. My personal concern with increasing HCG dosage is desensitizing and of course, permanent shutdown of the pituitary. What I hope this test will show is that I am indeed secondary (and not both) I think that my lab work pretty uch shows that my testicles are producing T but the LH signal is not working properly so I would expect that hitting it with the HCG should get the ball rolling so to speak. Also, when I first started the HCG my testicles started to ache (just like when I started the clomid) and I can tell there is a minor increase in the size (they have never been small).

My Doctor has a compounding pharmacy that he has been very happy with in FL. He ordered the HCG from them. The name escapes me at the moment. It is compounded and does not carry a name brand that I know of.

I inject into my stomach (my fat stomach I might add LOL) sub-q Saturday evenings at 10pm and Wednesday mornings before 10am. So far I have managed to stick to this protocol.

I was on Paxil for about 6 to 8 months in 2001. I went off it fairly quickly because I had sexual side effects from it - I started to have difficulty climaxing. Presently I am not taking anything at all in this area and haven't for about 4 or 5 years. I replaced the paxil with HERB PHARM Good mood tonic which worked very well in controlling panic attacks.

I agree with your last paragraph regarding the anastrozole. The clomid doubled my E2 (at least it appeared that way from the last blood test I had done.) But as you can see from my other labs, I have been dealing with very low E2 for quite some time. Yes, I think it sucks. LOL From what I read, this is a big part of my ED issues.

Re-Ride · Mar 23, 2016

CSI007 said:
If I draw blood on Thursday of next week it will be about 24 hours after 500iu are administered and it will be 1000iu in the past 7 days.

You are still not understanding the fleeting nature of the endogenous T ! "Test in the trough" means you draw just before your next dose is due on the chosen protocol not after it. Testing as you plan will show you the maximum effect 500 IU are having on your production. Lets say that number is 726 ng/dl total T. At this point hCG is still signaling the Leydigs. The result shows that your body is replacing what is being continuously used at a rate sufficient to keep you in a healthy range.

What that result does not tell you is what is happening to serum t levels as they rapidly drop off as the hCG disappears.

You are not going to feel well or be in a healthy state comes Friday ( 48 hrs after hCG) or Saturday morning (72 hrs after hCG). if your serum T has dropped to 200 because your Leydigs have gone back to sleep.

An incorrect belief by many practitioners is that they need to reproduce the body's pulasatory release of LH. Dr. Saya explained this very well on a recent post here. No matter what injection protocol is chosen for hCG it will never be possible to mimic the body's release of LH. His post is essential reading for you and for your prescriber.

Your next hCG dose needs to be timed to occur at a reasonable point on the downward slope of decreasing serum T. Let's say your personal study demonstrates that your serum T declines to 200 at 72 hours. That's too low.

We have no way of knowing what your actual numbers are going to be. First we don't know if you need 350 or 500 IU to get you to 725 or whatever your serum T goal is. Second we can speculate that on average you will see an unacceptable drop in serum T at 72 hrs post hCG but only a personal study will demonstrate that.

You've also chosen subQ over IM. I don't have any data to support this but my guess is the muscle deposition does a better job slowly releasing hCG in to your blood stream than subQ. For many the ease of subQ outweighs any advantage that IM may have

Re-Ride · Mar 23, 2016

CSI007 said:
If the T comes back low I will certainly consider all options....

My personal concern with increasing HCG dosage is desensitizing and of course, permanent shutdown of the pituitary.

Let's see if we can stay on the Turnpike of Science and Reason without exiting at the scenic by-way over Mt. Flummox. Pulling over at the Grassy Knoll rest stop we stretch our legs and take in the Exhibit of Fanciful Analogies. The feature film in wide screen techinicolor leaves us a bit shaken. Fortunately, while relieving ourselves we begin to question the relevance of rat tumor cells marinating in a Petri dish to our own Leydigs.

Rest assured that if your Leydigs become damaged from any level of hCG you will be the first in clinical history and that includes folks taking 6,000 IU in a single injection as well as those taking 1,200 regularly for years.

If you decide to undertake TRT or long term hCG mono presumably you and your doc have determined that your axis isn't functioning and can not be encouraged to function normally on its own. If that's the case why be concerned that it -might- not return to very low functioning at some point down the road?

All the above is per my understanding. Rather than rely what any layman states in a forum or what rolls off the lips of an endocrinologist wise men do their own research and arrive at their own conclusions.

CSI007 · Mar 23, 2016

I understand the "test in the trough" idea. MY reasoning for testing 24 hours after my next injection (which I just took) would be to try to find the maximum T generated before the drop off starts to occur to see if the testicles are still working as intended. (maybe this wouldn't be 24 hours after injection? Maybe I should get the blood work done today?)

At this point I just want to verify through blood work that I can actually produce T on my own. Even though my LH was on the lower side of normal this point is kinda still up for debate because of the chemo drugs that I had. The only studies I could find on the subject only talk about immediate (post chemo and about 1 to 2 years later) fertility. Yes, I have felt like crap since I wrapped up chemo but I have declined over time but my sexual function has been perfectly fine except for Libido all the years prior to last year.

I think that once the above is established that a 72 hour test would be a great idea and get a good grasp on the timing of future injections.

Do you happen to know the thread name? Or perhaps a link to it that you are referring to. I'm not sure I read it yet and would love to and pass it along to my Dr.

I was only able to find one study regarding the leydig desensitizing and that did involve the rats. LOL

I did find another study that shows that intra muscular injections did actually last longer. However the same study shows that HCG has a half life of about 33 hours.

Re-Ride · Mar 23, 2016

A second peak in serum T has been reported. IIRC the dose was considerably higher in those studies.

Take a look at the insert that accompanies Novarel:
https://www.ferringfertility.com/downloads/novarelpi.pdf

recommendation for treating hypogonadic hypogonadism:

protocol #1: 500 to 1,000 USP Units three times a week for three weeks, followed by the same
dose twice a week for three weeks.

protocol #2: 4,000 USP Units three times weekly for six to nine months, following which the
dosage may be reduced to 2,000 USP Units three times weekly for an additional
three months.

Practitioners have been known to test for response by using single injections in the thousands. The conservative approach you are on seems sensible to me because it allows for gradual enlarging and even growth of new Leydigs that some researches believe occurs. If this is correct then three weeks may be too soon to observe your ultimate response to 500 IU dosing.

By accurately recording your consistent low level dosing as a pt with no prior exposure to hCG along with your post administration response you are adding to the knowledge base in a valuable way.

Recent work suggests LH receptors located outside the testes respond to low dose hCG. A reduction in pain, improved mood and other benefits may be unrelated to rising serum T.

The symptoms that men are seeking relief from and for which they are turning to hormone therapy as a last resort typically involve more than fertility. The most effective treatment is likely hormone in combination with supplements, herbs, diet, exercise and sleep improvement. This is confounding to medical doctors and the way they are trained to treat illness.

We will be looking forward to the posting of your lab results and your progress. Success with low dose low frequency hCG monotherapy would be welcome news.