If you're looking to preserve GnRH signaling in the presence of exogenous testosterone then you're pretty much limited to testosterone nasal gel, e.g. Natesto, or the combination of oral testosterone and enclomiphene. Alternatives are either less practical — e.g. injecting exogenous GnRH (gonadorelin) several times daily — or speculative — e.g. adding cistanche extract and enclomiphene to a conventional TRT protocol.
Plausible, though for me adding GnRH to TRT led to a much greater improvement than when adding hCG. LH is a pulsatile hormone, so I feel that SC/IM hCG is an imperfect replacement.
I'm not familiar with cistanche, would it be necessary for adding enclo to TRT?
And when you say adding GnRH led to an improvement, are you referring specifically to cognitive function? Did you get GnRH prescribed by a doctor and if so, how?
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