Minimum Effective Dose of HCG Weekly To Prevent Testicular Atrophy

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davidandrade

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Human Chorionic Gonadotropin (From the book Testosterone: A Mans Guide, amazon.com)

Human chorionic gonadotropin (HCG) (not to be confused with human growth hormone, or HGH) is a glycoprotein hormone that mimics LH (luteinizing hormone), produced in pregnancy by the developing embryo soon after conception and later by part of the placenta. Its role is to prevent the disintegration of the corpus luteum of the ovary and to maintain the progesterone production critical for pregnancy in women. It supports the normal development of an egg in a woman’s ovary, and stimulates the release of the egg during ovulation. HCG is used to cause ovulation and to treat infertility in women.

hcg.jpg

You’re probably asking yourself why you should care about this. But in men, HCG is also used in young boys when their testicles have not dropped down into the scrotum normally. Additionally, HCG is used to increase testicular size after long-term testosterone or anabolic steroid use.

Testosterone replacement therapy triggers the hypothalamus to shut down its production of GnRH (gonadotropin releasing hormone). Without GnRH, the pituitary gland stops releasing LH. Without LH the testes (testicles or gonads) shut down their production of testosterone. For males HCG closely resembles LH. If the testicles have shrunken after long-term testosterone use, they will likely begin to enlarge and start their testosterone production shortly after HCG therapy is instituted. HCG jump-starts your testes to produce testosterone and to increase their size.

HCG has also been shown to increase the amount of testosterone inside the testicles (Intratesticular testosterone or IT). The use of HCG alone to increase testosterone is not as popular as using testosterone replacement due to several factors: 1- cost since large doses of HCG would be required, 2- quality of life of HCG alone vs TRT may be worse (this has not been validated by comparison studies), 3- concerns about long term high dose HCG use and its potential effect on desensitization of Leydig cells to it.

When used in small doses 2-3 times per week along with testosterone replacement, HCG can reverse the decrease of intratesticular testosterone. HCG’s effect as a LH mimicker plus its ability to increase IT seem to be the reasons why men were able to preserve fertility (normal sperm) when using testosterone replacement plus 500 IU HCG every other day in Dr Lipshultz’ study (see study attached to this post). The main surprising result of that study is that normal sperm quality can be preserved by this combo even in the absence of FSH, a gonadotropin thought to be essential in sperm production.

Currently on 100mg Test Cyp injected shallow IM in deltoid once a week and HCG 500iu injected SubQ twice a week (1000iu weekly). The HCG makes me bloated like I'm pregnant. I do not care about fertility. I do care about minimizing testicular atrophy and want to maintain downstream neurosteroid production. What is the minimum weekly dose of HCG I can get away with for my needs. Hoping I can lower some of the bloating. Thanks!
 

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Defy Medical TRT clinic doctor
How long have you been on HCG? If only for a short time, it’s possible the bloating will resolve on its own if you allow your body to adjust. That being said, I started out on 500 is twice weekly just like you and ended up switching to 250 ius 3 times/week. I didn’t have bloating, but felt like my week was a little too up and down…hard to out my finger on it or describe it, but I was still dialing in at that point and decided to switch it up. And my personal theory is that lower doses reduce the likelihood of receptor burnout(plus taking the lowest effective dose of anything is generally a good approach). Have been on that dose for over a year and half and balls are as full as ever. Trying that approach for a few weeks to let your body adjust may help with the bloating. Then if it still persists maybe try dropping down to 200 three times/week and see if it’s any better. At some point you should be able to find a good trade off between testicular volume and amount of bloatiness…assuming it doesn’t resolve completely which hopefully it will.


And if you’re wondering, I take around 100-110 mg test/week(Mon., Wed., and Fri.) and take my HCG Tues., Thurs., and Sun. 250 ius each time for a total of 750/week.
 
Hi all,

Currently on 100mg Test Cyp injected shallow IM in deltoid once a week and HCG 500iu injected SubQ twice a week (1000iu weekly). The HCG makes me bloated like I'm pregnant. I do not care about fertility. I do care about minimizing testicular atrophy and want to maintain downstream neurosteroid production. What is the minimum weekly dose of HCG I can get away with for my needs. Hoping I can lower some of the bloating. Thanks!

Comes down to the minimum weekly dose needed in order to stimulate maximum ITT (intratesticular testosterone)!

* The sweet spot would most likely be 250-500 IU 2-3X weekly in order to stimulate maximum ITT (intratesticular testosterone) production which should have a strong impact on minimizing/preventing testicular atrophy and maintaining fertility






 
Hi all,

Currently on 100mg Test Cyp injected shallow IM in deltoid once a week and HCG 500iu injected SubQ twice a week (1000iu weekly). The HCG makes me bloated like I'm pregnant. I do not care about fertility. I do care about minimizing testicular atrophy and want to maintain downstream neurosteroid production. What is the minimum weekly dose of HCG I can get away with for my needs. Hoping I can lower some of the bloating. Thanks!

Something that needs to be stressed here is the only way for an individual to truly gauge what impact said dose of hCG or hCG + FSH would have on testicular volume one would need to have it measured using a prader orchidometer or ultrasonography pre/post TRT.

You would never truly know playing the guessing game!
 
Comes down to the minimum weekly dose needed in order to stimulate maximum ITT (intratesticular testosterone)!

* The sweet spot would most likely be 250-500 IU 2-3X weekly in order to stimulate maximum ITT (intratesticular testosterone) production which should have a strong impact on minimizing/preventing testicular atrophy and maintaining fertility






Thanks madman, great information! I currently inject test cyp once a week on Mondays, 100mg. I do this for simplicity and also because I haven't noticed much of a difference in terms of how I feel on 100mg once a week vs 50mg twice a week.

When it comes to HCG, would injecting 750iu - 1000iu once a week be just as effective at preventing testicular atrophy vs injecting the same amount over two or three injections throughout the week?
 
Thanks madman, great information! I currently inject test cyp once a week on Mondays, 100mg. I do this for simplicity and also because I haven't noticed much of a difference in terms of how I feel on 100mg once a week vs 50mg twice a week.

When it comes to HCG, would injecting 750iu - 1000iu once a week be just as effective at preventing testicular atrophy vs injecting the same amount over two or three injections throughout the week?

Dr. Lipshultz one of the top uros in the field especially when it comes to male fertility recommends 1500 IU once weekly to prevent/minimize testicular atrophy.
 
50 mg T and 500 IU hCG twice per week work for me for testicular atrophy and sex drive. If you take Cialis or a nitric oxide supplement like citrulline, the effect is enhanced.

There is some data on taurine.


 
I take 75iu per day (or 525iu per week) of HCG sub Q, and my testicles are the size they should be:)
You experience along with mine seem to suggest that(at least for some people) there are least effective doses that are significantly smaller than previously thought…at least with regard to atrophy, though fertility is probably a different conversation. Although going from 500 twice a week(1000 total) to 250 three times a week(750 total) doesn’t sound like much, that’s a 25% decrease that achieves the same results. That results in money saved, decreases likelihood of receptor burnout, probably decreases impact to other bodily systems, decreases likelihood of negative side effects, etc. This is just a theory of mine, but I think a lot of the reason for so many guys saying they don’t tolerate HCG is because they don’t dial in the dose and/or don’t give their body the few weeks(at least) needed to adjust to the protocol. For some reason we all agree that everyone is different and there are countless approaches to trt that one may need to think about when dialing in… but for lots of guys they assume that it 500 ius of HCG twice week doesn’t work for them within a week or two that it means they can’t tolerate HCG.
 
50 mg T and 500 IU hCG twice per week work for me for testicular atrophy and sex drive. If you take Cialis or a nitric oxide supplement like citrulline, the effect is enhanced.

There is some data on taurine.


Thank you Nelson! Very interesting regarding Taurine. There was also a study that showed taking NAC alongside HCG counteracts oxidative stress and prevents HCG-induced apoptosis in rat Leydig cells.
 
The minimum effective dose of HCG (human chorionic gonadotropin) to prevent testicular atrophy in men undergoing testosterone replacement therapy (TRT) appears to be around 500-1000 IU per week, administered in divided doses.

## Dosage Recommendations

Several studies and expert guidelines suggest the following dosing protocols:

- 250-500 IU injected subcutaneously 2-3 times per week[3][4]
- 350-500 IU injected subcutaneously twice weekly[5]
- 500 IU injected subcutaneously 3 times per week[8]

These low doses have been shown to be effective in maintaining intratesticular testosterone levels and testicular size in men on TRT.

## Mechanism of Action

HCG acts as an analog to luteinizing hormone (LH), stimulating testosterone production within the testes. By administering low-dose HCG alongside TRT, intratesticular testosterone levels can be preserved, preventing testicular atrophy that often occurs with exogenous testosterone use[9].

## Research Findings

A randomized controlled trial found that 250 IU of HCG administered every other day was sufficient to maintain significantly higher intratesticular testosterone levels compared to placebo in men with testosterone-induced gonadotropin suppression[9].

Another study demonstrated that even a low dose of 125-500 IU of HCG every other day was effective in preserving normal intratesticular testosterone concentrations during gonadotropin suppression[4].

## Considerations

While higher doses of HCG (1000-4000 IU) are sometimes used, particularly for fertility preservation, the lower doses appear adequate for preventing testicular atrophy in most men on TRT. It's important to note that individual responses may vary, and dosing should be personalized based on factors such as age, baseline testosterone levels, and duration of TRT[7].

Regular monitoring through blood tests is essential to adjust HCG dosing appropriately and manage potential side effects. Always consult with a healthcare provider to determine the optimal dosing regimen for your specific situation.

Citations:
[1] Targeting Micropenis, Supporting Fertility, and Increasing Testosterone Using hCG
[2] Low-dose hCG can prevent sterility in men prescribed testosterone
[3] Find Your Perfect hCG Dose as a Man
[4] Can hCG Revive Your Manhood?
[5] Can You Reverse Testicle Shrinkage After TRT? | Blog
[6] Testicular responses to hCG stimulation at varying doses in men with spinal cord injury - Spinal Cord
[7] How Often to Take HCG on TRT | Gents Doctor
[8] https://www.maleinfertilityguide.com/hcg
[9] https://www.edenclinic.co.uk/post/low-dose-hcg-for-men-on-trt
[10] https://tctmed.com/resource/hcg-low-testosterone-fertility/
[11] https://pmc.ncbi.nlm.nih.gov/articles/PMC6087849/
[12] https://www.drugs.com/dosage/chorionic-gonadotropin-hcg.html
[13] https://pmc.ncbi.nlm.nih.gov/articles/PMC3214853/
 
Thank you Nelson! Very interesting regarding Taurine. There was also a study that showed taking NAC alongside HCG counteracts oxidative stress and prevents HCG-induced apoptosis in rat Leydig cells.
But the article forgot to mention what the dosage of NAC should be for humans in this case:(
 
Thank you Nelson! Very interesting regarding Taurine. There was also a study that showed taking NAC alongside HCG counteracts oxidative stress and prevents HCG-induced apoptosis in rat Leydig cells.
Thank you Nelson! Very interesting regarding Taurine. There was also a study that showed taking NAC alongside HCG counteracts oxidative stress and prevents HCG-induced apoptosis in rat Leydig cells.
But the article forgot to mention what the human dosage of NAC should be in this case:(
 
 
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