switching clinics to get away from test/anastrazole mixture and Gonadorelin

[DizzyD]

Hello all,
I am a 32 year old male 6'-1" and 190 pounds. semi-athletic build with probably around 15% body fat and exercise regularly. Lifestyle over the last year: I lift weights 5 times a week and run about 6 miles per week. I have a pretty good diet and get plenty of sleep usually 8-10 hours per night. Over the last 6 months to a year i have been experiencing all the classic symptoms of low T. fatigue and brain fog unbearable to where it is a challenge to just send a few emails per day for my job. not building any muscle and steadily gaining fat. I came across a well-advertised online clinic who appeared to be a legit option and moved forward with the physical, blood test, and consultation. Total T was 305 ng/dl with Estradiol 9.8 pg/mL. They did not test for Free T, LH, FSH, or SHBG.

Admittedly i was excited to get on therapy after reading all of the great lifechanging results people talk about. In hindsight should have done more research beforehand but this is where I am. I did my first injection of 200mg test cyp w/ anastrazole mixed in yesterday (can't locate what dose of anastrazole it is). Gonadorelin (.1mg per week) is also part of the protocol but i have not injected any of this yet. I explained to the doctor during the consult that I want to preserve fertility and he said that is what the gonadorelin will accomplish.

Over the last day I've gone down the rabbit hole reading about anastrazole AI and gonadorelin. From my understanding the AI should not be mixed in with the testosterone because then you’re locked in to using it until the next batch arrives which for me is in 2 months. Using an AI like Anastrazole can possibly crash estradiol and it appears mine is already low to begin with. Mixtures like this don’t allow for any tweaking based on symptoms. I also read about how gonadorelin is not as proven to preserve testicle function compared to HCG and HCG is not available from this clinic. So in my eyes this is a higher fertility risk when I want to likely have kids within the next few years.

My plan is to stop injecting the T/AI mixture after the initial 200mg injection yesterday. From what I’ve read on forums this would not require any PCT medicine and I should be back to my old self in a few weeks. I have inquired with Defy Medical already and like how they offer custom protocols with AI’s separate and also the better known HCG. I realize it could be several months before this switch would occur and I'd like to also get a sperm analysis baseline during this time.

My questions are

1) should I inject the Gonadorelin given I only injected one 200mg dose of T/AI and plan to discontinue it until I can switch clinics? If so how much of the Gonadorelin? I am thinking maybe one weeks’ worth since that is the amount of test I administered but I am pretty much guessing.

2) when would be the best timing to get a baseline sperm analysis done since I may have diminished LH, FSH, and sperm over the next few weeks?

This forum is a wealth of info and I appreciate all the advice and support offered to posters. I realize I should have done all of this reading beforehand to prevent this kind of situation but perhaps it’s better late than never.

Thanks,

Dean

 

[Nelson Vergel]

I did my first injection of 200mg test cyp w/ anastrazole mixed in yesterday (can't locate what dose of anastrazole it is). Gonadorelin (.1mg per week) is also part of the protocol but i have not injected any of this yet. I explained to the doctor during the consult that I want to preserve fertility and he said that is what the gonadorelin will accomplish.

I think you are doing the right thing by switching away from a clinic that prescribed those two crazy products/ formulations. Most men do not need anastrozole and gonadorelin does not work, specially at that crazy low dose and frequency. Do you mind telling us the name of this clinic?

Gonadorelin to Replace hCG: Compounding pharmacy source

Hi all, Does anyone currently use or know of a compounding pharmacy producing gonadorelin other than Hallandale? Hallandale cannot ship to California unfortunately. Thank you!

www.excelmale.com

Crashed estradiol

 

[Cataceous]

As long as you're taking a step back from TRT anyway, consider a trial with a testosterone nasal gel as an alternative. The big advantage of this is that it is less disruptive of your naturally produced hormones. This means that you're more likely to retain fertility. Defy Medical can prescribe Empower's nasal gel product. For further research read about Natesto. For example:
Acerus Pharmaceuticals- NATESTO® | Excel Male TRT Forum

 

[DizzyD]

I think you are doing the right thing by switching away from a clinic that prescribed those two crazy products/ formulations. Most men do not need anastrozole and gonadorelin does not work, specially at that crazy low dose and frequency. Do you mind telling us the name of this clinic?

Gonadorelin to Replace hCG: Compounding pharmacy source

Hi all, Does anyone currently use or know of a compounding pharmacy producing gonadorelin other than Hallandale? Hallandale cannot ship to California unfortunately. Thank you!

www.excelmale.com

Crashed estradiol

It is RMC. So do you recommend not taking any of the Gonadorelin? Any advice on when would be the best time to get the baseline sperm test?

 

[madman]

Hello all,
I am a 32 year old male 6'-1" and 190 pounds. semi-athletic build with probably around 15% body fat and exercise regularly. Lifestyle over the last year: I lift weights 5 times a week and run about 6 miles per week. I have a pretty good diet and get plenty of sleep usually 8-10 hours per night. Over the last 6 months to a year i have been experiencing all the classic symptoms of low T. fatigue and brain fog unbearable to where it is a challenge to just send a few emails per day for my job. not building any muscle and steadily gaining fat. I came across a well-advertised online clinic who appeared to be a legit option and moved forward with the physical, blood test, and consultation. Total T was 305 ng/dl with Estradiol 9.8 pg/mL. They did not test for Free T, LH, FSH, or SHBG.

Admittedly i was excited to get on therapy after reading all of the great lifechanging results people talk about. In hindsight should have done more research beforehand but this is where I am. I did my first injection of 200mg test cyp w/ anastrazole mixed in yesterday (can't locate what dose of anastrazole it is). Gonadorelin (.1mg per week) is also part of the protocol but i have not injected any of this yet. I explained to the doctor during the consult that I want to preserve fertility and he said that is what the gonadorelin will accomplish.

Over the last day I've gone down the rabbit hole reading about anastrazole AI and gonadorelin. From my understanding the AI should not be mixed in with the testosterone because then you’re locked in to using it until the next batch arrives which for me is in 2 months. Using an AI like Anastrazole can possibly crash estradiol and it appears mine is already low to begin with. Mixtures like this don’t allow for any tweaking based on symptoms. I also read about how gonadorelin is not as proven to preserve testicle function compared to HCG and HCG is not available from this clinic. So in my eyes this is a higher fertility risk when I want to likely have kids within the next few years.

My plan is to stop injecting the T/AI mixture after the initial 200mg injection yesterday. From what I’ve read on forums this would not require any PCT medicine and I should be back to my old self in a few weeks. I have inquired with Defy Medical already and like how they offer custom protocols with AI’s separate and also the better known HCG. I realize it could be several months before this switch would occur and I'd like to also get a sperm analysis baseline during this time.

My questions are

1) should I inject the Gonadorelin given I only injected one 200mg dose of T/AI and plan to discontinue it until I can switch clinics? If so how much of the Gonadorelin? I am thinking maybe one weeks’ worth since that is the amount of test I administered but I am pretty much guessing.

2) when would be the best timing to get a baseline sperm analysis done since I may have diminished LH, FSH, and sperm over the next few weeks?

This forum is a wealth of info and I appreciate all the advice and support offered to posters. I realize I should have done all of this reading beforehand to prevent this kind of situation but perhaps it’s better late than never.

Thanks,

Dean

Starting someone off on a whopping dose of T (200mg/week) off the hop should have been a red flag right away.

Let alone throwing in the AI and gonadorelin to top it off!

This would have most men's TT, FT, and estradiol (without AI) through the roof, and in many cases depending on the injection frequency used 200 mg/week split (twice weekly, M/W/F, EOD, or daily) would have trough levels absurdly high!

The best piece is advice is to start low and go slow (T only) protocol to see how you react to the said dose of T as we want to see where such protocol (dose T/injection frequency) has your trough TT, FT, estradiol let alone other blood markers such as RBCs/hemoglobin/hematocrit.

The use of ancillaries.....hCG can be added after blood work is done at 6 weeks (blood levels stabilize).

Would be more sensible to avoid the use of an AI if possible and even then if you are one who needs to rely on such then micro-doses would be needed.

Keep in mind that driving e2 too low can have many negative effects on overall health.


The metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects.

Mood, energy, libido, erectile function, cardiovascular/brain/bone/immune system health, body composition.

 

[madman]

It is RMC. So do you recommend not taking any of the Gonadorelin? Any advice on when would be the best time to get the baseline sperm test?

Standard cookie-cutter protocol.....run-of-the-mill T-clinic!

post #20

TRT testicular atrophy

Hi, im 24 and was type 2 hypogonadal. Had a inexperienced Dr, currently in South America so low on options. Got told I would be infertile if I continued on trt 125mg / week. The testicular atrophy has started to worry me due to one Dr.'s comments on my risk on fertility. Further listening to his...

www.excelmale.com

 

[Jason Sypolt]

Do not take the gonadorelin. Some clinics like Royal are pushing that when they can’t get HCG to keep their profits up. There is NO substitute or replacement for HCG. I can’t tell you how many times I have heard of people begging to get away from gonadorelin and they are scared of what it is doing to them because they were told to take it in place of HCG and they feel like they can’t leave their own home. Some uses of gonadorelin are: to stop early puberty and as a form of chemical castration of sex offenders in some countries.

Defy totally changed my life years ago with HRT and later moved me to FL to work there. Get the labs and listen to what the provider says. There is no blended Anastrozole and no sub-par substituted products. They come from Enpower in Houston, one of the largest compounding pharmacies in the world.

You will probably be given options to start with an injection or cream. The nasal gel is an excellent booster, but it’s not a good choice for primary treatment. You have to dose it multiple times per day and serum levels increase by 800-1000 ng/dL. It gives some people a stuffy nose. The nasal gel is often prescribed PRN 8 clicks in each nostril 30-60 minutes before workouts or sex and it works very well for that. I keep a couple of pens in my bags. No come down or crash. In all honesty there is nothing natural about that or any of this replacement that we are doing. And it’s for the rest of your life, so keep it simple and you will thank yourself in hindsight. Do what works for you, but try the common options and listen to the provider because they know what works to get people feeling well fast from experience.

Side note: if you want to try something that is still relatively unknown but getting really good feedback, ask Defy about the testosterone hydrogel. I’m switching to it myself in place of T and Stanozolol cream next week.

 

[Cataceous]

Do not take the gonadorelin. Some clinics like Royal are pushing that when they can’t get HCG to keep their profits up. There is NO substitute or replacement for HCG. I can’t tell you how many times I have heard of people begging to get away from gonadorelin and they are scared of what it is doing to them because they were told to take it in place of HCG and they feel like they can’t leave their own home. ...
...

I agree that the OP should not start gonadorelin. It won't help him recover from the single large dose of testosterone.

Beyond that, however, I'd like to know if you now have some tangible evidence against gonadorelin. Although I'm skeptical of Royal's protocol, they have at least put forth data showing normalized LH and FSH. There remain unanswered questions: Were the measurements made shortly after injections? If so, are the gonadotropins otherwise very low? Is testicular atrophy prevented? What are the subjective results?

There are many unanswered questions about your account too: Why are people "begging to get away from gonadorelin"? What protocols are they on? What does it mean to say "they feel like they can’t leave their own home"? There's some kind of severe mental stress caused by the drug? Agoraphobia? These are not among the commonly reported side effects.

I think it's unreasonable to demonize gonadorelin per se, which is actually more natural in the male body than hCG. Either substance can be misused in shoddy protocols. Personally I find hCG to be the poor substitute for gonadorelin.

... Some uses of gonadorelin are: to stop early puberty and as a form of chemical castration of sex offenders in some countries. ...

You are conflating gonadorelin with other GnRH agonists. Gonadorelin has too short of a half-life to perform these functions; it would only work with continuous infusion. Some drugs actually used for these purposes include buserelin, leuprorelin, nafarelin, and triptorelin.

 

[Jason Sypolt]

I agree that the OP should not start gonadorelin. It won't help him recover from the single large dose of testosterone.

Beyond that, however, I'd like to know if you now have some tangible evidence against gonadorelin. Although I'm skeptical of Royal's protocol, they have at least put forth data showing normalized LH and FSH. There remain unanswered questions: Were the measurements made shortly after injections? If so, are the gonadotropins otherwise very low? Is testicular atrophy prevented? What are the subjective results?

There are many unanswered questions about your account too: Why are people "begging to get away from gonadorelin"? What protocols are they on? What does it mean to say "they feel like they can’t leave their own home"? There's some kind of severe mental stress caused by the drug? Agoraphobia? These are not among the commonly reported side effects.

I think it's unreasonable to demonize gonadorelin per se, which is actually more natural in the male body than hCG. Either substance can be misused in shoddy protocols. Personally I find hCG to be the poor substitute for gonadorelin.


You are conflating gonadorelin with other GnRH agonists. Gonadorelin has too short of a half-life to perform these functions; it would only work with continuous infusion. Some drugs actually used for these purposes include buserelin, leuprorelin, nafarelin, and triptorelin.

Cataceous, I have heard the phone calls and seen the emails. No, as I said before, I cannot share them. You are intelligent enough to know why and understand that. The drug is not being used according to the FDA indications with the associated side effects when used for those indications. The same drug can have different benefits and side effect profiles when used in different ways and at different doses. These clinics are prescribing it as "it's the same thing as HCG". This is the real world use of what really happens and not a science class reading papers. You could as an option try a similar protocol on yourself if you are inclined and really want to know.

And the Royal Gonadorelin vs HCG page.... What data? I'm honestly a bit shocked that anyone is willing to consider such a claim from some heavily cropped screenshots that could be from any lab results. Only 2 of the clips even have dates on them. That's like buying a used car based only from looking at cropped manufacturer photos of the good parts. I see threads of patients asking about and for HCG. I don't see threads of patients saying others should try gonadorelin because it works so well or even better given that clinics have been sending it to patients for nearly a year and a half at this point. Where are the (any?) success stories? Your thread here is the only one reporting a small increase in LH from micro-dosing although the experiment was tainted since you were taking clomid or enclomiphene whichever it was along with if I recall the gonadorelin being from a peptide site presumably because no one would prescribe it. That last part is actually pretty funny if you consider all of the irony around it.

It has been over a year since the biologic reclassification. Then we saw HCG shortages because of API backorders, limited commercial HCG to replace compounded since it is a niche fertility market, and last month the CA pharmacy board outright banned all compounded HCG within and outside of the state - those guys have 100% no other HCG option. No successes being seen and widely reported on and no gonadorelin prescribed by providers other than from doctors/clinics you mostly never heard of.

All that was not to convince you Cataceous, I know it won't and I don't care to. I left some of your argument alone so that you can still be right. This is just a warning to patients reading. For your own sanity and well-being, don't take gonadorelin.

 

[Cataceous]

Cataceous, I have heard the phone calls and seen the emails. No, as I said before, I cannot share them. You are intelligent enough to know why and understand that. The drug is not being used according to the FDA indications with the associated side effects when used for those indications. The same drug can have different benefits and side effect profiles when used in different ways and at different doses. These clinics are prescribing it as "it's the same thing as HCG". This is the real world use of what really happens and not a science class reading papers. You could as an option try a similar protocol on yourself if you are inclined and really want to know.
...

I'll repeat the standard disclaimer: I've never said that gonadorelin is a practical replacement for hCG. It works for me, but with a complex protocol that most would find difficult to stay with. Another guy has tried it, getting decent quantitative results but poor subjective results. We speculate that enclomiphene was problematic for him because he has less aromatization than I.

With that part out of the way, I ask you those questions out of genuine interest, not to win some debate. None of those questions requires any personally identifiable information; nobody's privacy would be violated if you were a little more specific about the possible hazards of gonadorelin. Without additional information the vague statements have less weight than the limited data RMC is putting forth. RMC is making rather concrete claims—that gonadorelin injections are leading to normal LH and FSH, albeit probably transiently. If these are outright fabrications then it would seem to open them to civil or criminal liability.

I would absolutely like to see some anecdotes about the RMC gonadorelin protocol. You point out that we're not seeing success stories. But statistically speaking we should be seeing the stories of failure at a higher rate, as these are more commonly what end up in the forums—because guys want help.

Of what do you think I should be convinced? Is it that guys should be steered towards hCG rather than gonadorelin? Already there. Is it that gonadorelin isn't working for me? Not happening. Is it that my protocol is unsafe? I'm more concerned about the enclomiphene than the gonadorelin when it comes to long-term use. Is it that RMC's protocol is unsafe? It's not impossible given the large size of the single dose; continuous protocols in the literature max out around 30 mcg 16 times a day. RMC's protocol may be 100 mcg twice a week. So about three times the max known dose. Not outlandish, but I suppose it could cause troubles for some. This is why I'd like to know more about the problems you mention.

 

[Jason Sypolt]

Fair enough, the symptoms are often described as a new low mood, brain fog, anxiety, "feel like shit". Two that I can recall said they had such high anxiety that they genuinely feared leaving home, were scared and didn't know what else to do. Within 2-4 weeks of taking it. The symptoms present themselves as seeming like the onset of depression and hypogonadism even though they have already been on TRT for some time. Headache and dizziness were reported, although that could be anything and is also common with many medications.

What has been happening to people is that a clinic will ship a patient gonadorelin in place of HCG without mention of any change. If a patient asks, someone at the clinic tells them "it's the same as HCG". And there are few if any answers to side effects so they reach out to someone else for help. It's much more than 100mcg twice a week. Some clinics are telling people to inject 0.5mL or 500mcg of gonadorelin once or twice a week, similar to what you could see with a 500IU BIW protocol of HCG. I suppose that is part of the "it's the same illusion".

 

[Cataceous]

Fair enough, the symptoms are often described as a new low mood, brain fog, anxiety, "feel like shit". Two that I can recall said they had such high anxiety that they genuinely feared leaving home, were scared and didn't know what else to do. Within 2-4 weeks of taking it. The symptoms present themselves as seeming like the onset of depression and hypogonadism even though they have already been on TRT for some time. Headache and dizziness were reported, although that could be anything and is also common with many medications.

What has been happening to people is that a clinic will ship a patient gonadorelin in place of HCG without mention of any change. If a patient asks, someone at the clinic tells them "it's the same as HCG". And there are few if any answers to side effects so they reach out to someone else for help. It's much more than 100mcg twice a week. Some clinics are telling people to inject 0.5mL or 500mcg of gonadorelin once or twice a week, similar to what you could see with a 500IU BIW protocol of HCG. I suppose that is part of the "it's the same illusion".

Thanks for that. It sheds more light on the situation. What you're describing sounds like malpractice. It's akin to a doctor prescribing a gram of testosterone cypionate a week to a typical hypogonadal patient; there's no medical justification and it can result in harm. But in such cases we don't blame the testosterone—we blame the doctor. Testosterone is fine when used correctly, and the same applies to gonadorelin.

 

[DizzyD]

Update: 10 days after my initial 200mg injection bloodwork came back at 446 total T (up from 305 previous) and 9.1 free T. LH near zero. I had my sperm analyzed around this same time and it was viable with 70 million motile sperm count. Had 4 vials frozen. I spoke to Ben at Defy for the consultation and he was very helpful with everything. Starting off next week at 180mg per week injecting 3x per week. Also HcG and AI separate. Thanks everyone for the responses and insight.

 

[fof99]

Do not take the gonadorelin. Some clinics like Royal are pushing that when they can’t get HCG to keep their profits up. There is NO substitute or replacement for HCG. I can’t tell you how many times I have heard of people begging to get away from gonadorelin and they are scared of what it is doing to them because they were told to take it in place of HCG and they feel like they can’t leave their own home. Some uses of gonadorelin are: to stop early puberty and as a form of chemical castration of sex offenders in some countries.

Defy totally changed my life years ago with HRT and later moved me to FL to work there. Get the labs and listen to what the provider says. There is no blended Anastrozole and no sub-par substituted products. They come from Enpower in Houston, one of the largest compounding pharmacies in the world.

You will probably be given options to start with an injection or cream. The nasal gel is an excellent booster, but it’s not a good choice for primary treatment. You have to dose it multiple times per day and serum levels increase by 800-1000 ng/dL. It gives some people a stuffy nose. The nasal gel is often prescribed PRN 8 clicks in each nostril 30-60 minutes before workouts or sex and it works very well for that. I keep a couple of pens in my bags. No come down or crash. In all honesty there is nothing natural about that or any of this replacement that we are doing. And it’s for the rest of your life, so keep it simple and you will thank yourself in hindsight. Do what works for you, but try the common options and listen to the provider because they know what works to get people feeling well fast from experience.

Side note: if you want to try something that is still relatively unknown but getting really good feedback, ask Defy about the testosterone hydrogel. I’m switching to it myself in place of T and Stanozolol cream next week.

Having the same issue with Royal, is there a better clinic you could recommend that is in the price range of royal?

 

[fof99]

Hello all,
I am a 32 year old male 6'-1" and 190 pounds. semi-athletic build with probably around 15% body fat and exercise regularly. Lifestyle over the last year: I lift weights 5 times a week and run about 6 miles per week. I have a pretty good diet and get plenty of sleep usually 8-10 hours per night. Over the last 6 months to a year i have been experiencing all the classic symptoms of low T. fatigue and brain fog unbearable to where it is a challenge to just send a few emails per day for my job. not building any muscle and steadily gaining fat. I came across a well-advertised online clinic who appeared to be a legit option and moved forward with the physical, blood test, and consultation. Total T was 305 ng/dl with Estradiol 9.8 pg/mL. They did not test for Free T, LH, FSH, or SHBG.

Admittedly i was excited to get on therapy after reading all of the great lifechanging results people talk about. In hindsight should have done more research beforehand but this is where I am. I did my first injection of 200mg test cyp w/ anastrazole mixed in yesterday (can't locate what dose of anastrazole it is). Gonadorelin (.1mg per week) is also part of the protocol but i have not injected any of this yet. I explained to the doctor during the consult that I want to preserve fertility and he said that is what the gonadorelin will accomplish.

Over the last day I've gone down the rabbit hole reading about anastrazole AI and gonadorelin. From my understanding the AI should not be mixed in with the testosterone because then you’re locked in to using it until the next batch arrives which for me is in 2 months. Using an AI like Anastrazole can possibly crash estradiol and it appears mine is already low to begin with. Mixtures like this don’t allow for any tweaking based on symptoms. I also read about how gonadorelin is not as proven to preserve testicle function compared to HCG and HCG is not available from this clinic. So in my eyes this is a higher fertility risk when I want to likely have kids within the next few years.

My plan is to stop injecting the T/AI mixture after the initial 200mg injection yesterday. From what I’ve read on forums this would not require any PCT medicine and I should be back to my old self in a few weeks. I have inquired with Defy Medical already and like how they offer custom protocols with AI’s separate and also the better known HCG. I realize it could be several months before this switch would occur and I'd like to also get a sperm analysis baseline during this time.

My questions are

1) should I inject the Gonadorelin given I only injected one 200mg dose of T/AI and plan to discontinue it until I can switch clinics? If so how much of the Gonadorelin? I am thinking maybe one weeks’ worth since that is the amount of test I administered but I am pretty much guessing.

2) when would be the best timing to get a baseline sperm analysis done since I may have diminished LH, FSH, and sperm over the next few weeks?

This forum is a wealth of info and I appreciate all the advice and support offered to posters. I realize I should have done all of this reading beforehand to prevent this kind of situation but perhaps it’s better late than never.

Thanks,

Dean

Hey Dean, curious if you switched clinics. I had the same issue with RMC, if so do you mind if I ask if you found somewhere with a similar price range?

 

[jorgsmash]

How is anyone affording HCG right now? My clinic quoted over $500/mo for it.

 

[Nelson Vergel]

ow is anyone affording HCG right now? My clinic quoted over $500/mo for it.

Doctors can call in a prescription to a regular pharmacy. Some guys get it on ReliableRX also.

These are the current prices for 10,000 IUs. They keep going up and some phramacies have it on backorder.

https://www.goodrx.com/hcg

Guys that are using DefyMedical.com are paying a lower price. I think Defy found a deal with a distributor.

 

[JmarkH]

I started ordering mine from ReliableRX. An India pharmacy.

 

[haynewp]

I’m glad I saw this thread. My clinic sold me 10 weeks of Gonadorelin that I started to microdose daily in hopes of getting some kind of benefit but now I will just throw it in the trash.

 

[Cataceous]

I’m glad I saw this thread. My clinic sold me 10 weeks of Gonadorelin that I started to microdose daily in hopes of getting some kind of benefit but now I will just throw it in the trash.

If the doses are reasonable, i.e. 10-30 mcg, then I'd encourage you to continue the experiment to see if you perceive any benefits. This protocol is unlikely to generate downstream hormones, such as LH and FSH. Nonetheless, I think it's possible that restoring even a little GnRH signaling is preferable to leaving it fully suppressed; GnRH appears to have functions that are independent of the HPTA.