Need serious help/advice

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SixHouse

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I'll try to make this short. I'm 44, 6' 210# healthy and in very good physical shape. Gym 6 days a week, my diet is better than most, don't drink or smoke.

I have a rx for Testosterone Cypionate and have been injecting 100mg (.5 cc) once a week. On the 3rd or 4th day after injecting my blood work shows testosterone level of roughly 1,000. I have been doing this for about 2 years now.

I have ZERO sex drive. Literally ZERO. It has been low for a long time but now it is gone. I used to be able to take a Viagra and perform like a rock star even if my brain wasn't in the mood, but now even that doesn't work. I understand this can all be a side effect with long term TRT.

After a lot of research I went to my urologist yesterday to discuss HCG. There are reports of HCG not only bringing back testicular function, but also libido. He was not familiar with this concept and told me he prescribes HCG alone for his fertility patients, but has never prescribed HCG in conjunction with testosterone. He sat with me for 30 mins watching YouTube videos and reading forums like this one and decided that he was now very curious so I'd be the guinea pig. He wrote me a rx for HCG.

I have a lot of questions because he really couldn't tell me what to do as far as concentration and dosage. If someone could take the time to answer each of my concerns I would really appreciate it... so would my wife.

1) I was thinking maybe I should stop the testosterone all together for a little while, give my body a few weeks (months?) to get back to my normal. I could do the HCG during this time to get things moving. Is this a good idea, or should I continue the testosterone and add the HCG?

2) Maybe I should stop everything for a little while then start testosterone and HCG together?

Dosage...

3) I have the 10,000 unit bottle of HCG. I have seen guys fill it with 10cc water or 5cc water. I get that this will determine the HCG concentration in equal amounts of liquid. Are they just doing this to control the amount of liquid they inject?

In the Excelmale YouTube video Nelson Vergel says he does the same amount of testosterone I'm doing (100mg per week) but spaced out over 2 weekly injections of .25cc each. Then he says his HCG comes in a 11,000 unit bottle (mine is 10,000). He mixes 5.5cc water into his bottle and just like the testosterone he injects .25cc twice a week of HCG to get 500iu per injection.

4) Would anyone recommend I do the same? 100mg Testosterone + 1000iu HCG per week broken into 2 injections per week, or should I start with 500iu HCG?

If you can think of ANYTHING else please tell me. At my wit's end here :(
 
Defy Medical TRT clinic doctor
I'll try to make this short. I'm 44, 6' 210# healthy and in very good physical shape. Gym 6 days a week, my diet is better than most, don't drink or smoke.

I have a rx for Testosterone Cypionate and have been injecting 100mg (.5 cc) once a week. On the 3rd or 4th day after injecting my blood work shows testosterone level of roughly 1,000. I have been doing this for about 2 years now.

I have ZERO sex drive. Literally ZERO. It has been low for a long time but now it is gone. I used to be able to take a Viagra and perform like a rock star even if my brain wasn't in the mood, but now even that doesn't work. I understand this can all be a side effect with long term TRT.

After a lot of research I went to my urologist yesterday to discuss HCG. There are reports of HCG not only bringing back testicular function, but also libido. He was not familiar with this concept and told me he prescribes HCG alone for his fertility patients, but has never prescribed HCG in conjunction with testosterone. He sat with me for 30 mins watching YouTube videos and reading forums like this one and decided that he was now very curious so I'd be the guinea pig. He wrote me a rx for HCG.

I have a lot of questions because he really couldn't tell me what to do as far as concentration and dosage. If someone could take the time to answer each of my concerns I would really appreciate it... so would my wife.

1) I was thinking maybe I should stop the testosterone all together for a little while, give my body a few weeks (months?) to get back to my normal. I could do the HCG during this time to get things moving. Is this a good idea, or should I continue the testosterone and add the HCG?

2) Maybe I should stop everything for a little while then start testosterone and HCG together?

Dosage...

3) I have the 10,000 unit bottle of HCG. I have seen guys fill it with 10cc water or 5cc water. I get that this will determine the HCG concentration in equal amounts of liquid. Are they just doing this to control the amount of liquid they inject?

In the Excelmale YouTube video Nelson Vergel says he does the same amount of testosterone I'm doing (100mg per week) but spaced out over 2 weekly injections of .25cc each. Then he says his HCG comes in a 11,000 unit bottle (mine is 10,000). He mixes 5.5cc water into his bottle and just like the testosterone he injects .25cc twice a week of HCG to get 500iu per injection.

4) Would anyone recommend I do the same? 100mg Testosterone + 1000iu HCG per week broken into 2 injections per week, or should I start with 500iu HCG?

If you can think of ANYTHING else please tell me. At my wit's end here :(

Welcome to Excelmale.

You reference your total testosterone level, what about your free testosterone, estradiol, SHBG, and DHT values? Can you post them, along with the associated reference ranges?

Why are you on testosterone? What was the symptom and lab picture that resulted in your initiating therapy? I ask because your thoughts of stopping therapy and returning to "normal" (as you put it) suggest you are considering a restart. But that typically requires the use of Clomid (and an experienced doctor), along with a diagnosis of secondary hypogonadism. Your doctor seems to be kind and open to discussion, but hardly working on the cutting edge of androgen therapy.

A bit more context will focus the discussion.
 
Welcome to Excelmale.

You reference your total testosterone level, what about your free testosterone, estradiol, SHBG, and DHT values? Can you post them, along with the associated reference ranges?

Why are you on testosterone? What was the symptom and lab picture that resulted in your initiating therapy? I ask because your thoughts of stopping therapy and returning to "normal" (as you put it) suggest you are considering a restart. But that typically requires the use of Clomid (and an experienced doctor), along with a diagnosis of secondary hypogonadism. Your doctor seems to be kind and open to discussion, but hardly working on the cutting edge of androgen therapy.

A bit more context will focus the discussion.


Originally complained of feeling blah, tired, low sex drive. Initial urologist visit found total testosterone around 300. He said, "eh... that's probably low. No way to know how low it is for YOU, but we can raise it and see how you feel." So we started with Testim (gel). I hated having sticky shirts and didn't notice any change after several weeks. Switched to Axiron (underarm), also no change after several weeks. Finally started injections. Initially was doing 200mg Cypionate every 10 days. This was 5 years ago so I don't know if this is a real memory, but I want to say that after a few weeks I felt great. High libido etc. I started getting really bad flu-like symptoms and my nuts pretty much disappeared. Switched to 200mg every 14 days. Roller coaster spikes were no good. This all went on for over a year. Finally I stopped cold turkey. Had more labs after several weeks and things were back to "normal." Even did a semanalysis and found very high/strong sperm count. But very low libido again. Decided to start Cypionate again but this time 100mg per week. Again I think I remember an initial boost, but over the last year just a steady decline until I got to where I am now.

Attaching my most recent labs...

Untitled-1.jpg
 
I would keep your current testosterone dose and add 500iu of HCG every 3 1/2 days. That my protocol for HCG.
 
Vince gave you good advice on just adding HCG, there's no reason at all to stop everything and restart, hormones take time and you can undo the little progress you have made to this point.
We always test in the trough right before the injection thats the only strategy we employ for testing.
 
Vince gave you good advice on just adding HCG, there's no reason at all to stop everything and restart, hormones take time and you can undo the little progress you have made to this point.
We always test in the trough right before the injection thats the only strategy we employ for testing.

Sorry what do you mean by "test in the trough"?
 
The trough is the lowest point between injections, it is right before you are due for your next injection and it is the time for a blood draw.
 
I agree with the advice 100%. Definitely make sure you get the testing done at trough with the correct e2 test. If that's an hcg day I'd take it after the test. You should be able to get things figured out at that point. Decent change you want to bump up the T dose just a bit, but maybe not.
 
Thanks everyone. I actually made an appointment tomorrow at Defy Medical in Tampa. In the mean time I'm going to start doing 50mg Cypionate + 500mg HCG twice a week.

Question...

I have always injected into the glute with a 1.5" needle. Rather not do that twice a week. My shoulders are pretty well developed with very little fat. Will the 27 gauge .5" needle be ok for me, or should I go deeper with a 1" needle?
 
I'm sorta new to all this stuff too but some observations. Splitting up the T more then twice a week might be helpful (EOD) I have seen marked improvement going from twice a week to EOD. I feel much better. My libido has been unbelievable from the start of injections and it continues. But I was on HCG monotherapy. I am now doing 400iu twice per week of HCG to see if I can get my E2 down just a bit - it was not terribly high (low to mid 30's with high range being 32). Sex for my wife and I occurred maybe once or twice a month before I started injections. Now it's multiple times a week. And if I could get the crap down there working correctly it would be twice a day!

It could be that your just not "balanced enough each week and you are seeing too many swings or it could just be that you need some HCG thrown into the mix. Good luck to you! There are lots of very helpful people here so you found the right place to ask questions. :)

Your E2 level looks about right if not a bit low perhaps, usually from what I have read the sensitive test will usually come in lower then the standard E2.
 
Thanks everyone. I actually made an appointment tomorrow at Defy Medical in Tampa. In the mean time I'm going to start doing 50mg Cypionate + 500mg HCG twice a week.

Question...

I have always injected into the glute with a 1.5" needle. Rather not do that twice a week. My shoulders are pretty well developed with very little fat. Will the 27 gauge .5" needle be ok for me, or should I go deeper with a 1" needle?
The only syringe I use for both testosterone and HCG, is the Easy Touch 27g 1/2 syringe for a nice shallow IM.
 
Beyond Testosterone Book by Nelson Vergel
I'm sorta new to all this stuff too but some observations. Splitting up the T more then twice a week might be helpful (EOD) I have seen marked improvement going from twice a week to EOD. I feel much better. My libido has been unbelievable from the start of injections and it continues. But I was on HCG monotherapy. I am now doing 400iu twice per week of HCG to see if I can get my E2 down just a bit - it was not terribly high (low to mid 30's with high range being 32). Sex for my wife and I occurred maybe once or twice a month before I started injections. Now it's multiple times a week. And if I could get the crap down there working correctly it would be twice a day!

It could be that your just not "balanced enough each week and you are seeing too many swings or it could just be that you need some HCG thrown into the mix. Good luck to you! There are lots of very helpful people here so you found the right place to ask questions. :)

Your E2 level looks about right if not a bit low perhaps, usually from what I have read the sensitive test will usually come in lower then the standard E2.


Thanks! How much testosterone are you doing EOD?
 
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