What is the best dose of HCG? Dr Saya presents two case studies.

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Community - I am sharing and have attached the write-up of a recent small case study I have conducted on quantitative serum beta hCG concentrations relating to hCG injections. This study is limited to dosages of 150iu and 500iu, although I hope to obtain more data in the near future.

P.S. Attempted to copy/paste plain text for those that may have a challenge viewing the pdf on mobile, but formatting wouldn't cooperate.
This is a very interesting study on HCG. Lipshultz protocol for HCG is 500iu EOD which is 250iu daily, is it the equivalent in terms of continuity and regularity or even better to inject daily rather than EOD?
 
Defy Medical TRT clinic doctor
Many potential reasons for variation in T levels, with leydig cell desensitization (per your concern) being a very unlikely one at your doses. Variation in timing of T injection or variable leydig response to individual HCG injections are possibilities. My opinion would be to hold steady on regimen and recheck.

Hey question, what E2 level would you consider high?
I’m doing 100mg 2x a week and HCG 150iu 4x a week since I’m low shgb. (16)
My e2 hovers between 35-45 sensitive.
I feel great I’m a lean guy no fat.
 
Hey question, what E2 level would you consider high?
I’m doing 100mg 2x a week and HCG 150iu 4x a week since I’m low shgb. (16)
My e2 hovers between 35-45 sensitive.
I feel great I’m a lean guy no fat.

You’re on a TRT dosage on the upper end of the bell curve, so I would suspect your T is around 1000-1200 or so. Assuming that, you’re E is arguably proportionate. The prevailing wisdom at this time dictates that in the absence of symptoms, your E2 level should be fine.
 
You’re on a TRT dosage on the upper end of the bell curve, so I would suspect your T is around 1000-1200 or so. Assuming that, you’re E is arguably proportionate. The prevailing wisdom at this time dictates that in the absence of symptoms, your E2 level should be fine.

your close! 971. Thanks for the reply. Look forward to your continued work.
 

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"What is the best dose of HCG?"

More? I don't know how rare it is, but I have almost always felt better on more and more hcg in addition to my trt. Never used more than 1500/wk. I can remember at the very beginning of treatment where I was noticing the 2nd dose of 500 each week was making me irritable. That was the first time ever my e2 came above range...years ago. Now I've experimented enough to know that hcg is a big plus in my book.

I inject hcg daily. Looking to back that off a bit at some point, but based on the half life, i'm not sure that would work so well.
So you were on 1,000iu of HCG per week before I take. I’m on 500iu EOD which totals 1,750iu weekly (250iu daily). My testicles look normal but my semen has changed to a saliva-like consistency (odorless though).Does this happen to you if I may ask? My mood is fine, no swings whatsoever just like you on a similar dose.
 
Kind of off topic but a guy claimed he healed from PFS from using HCG 500iu every day for 30 days, nolvadex for 45 days(I'm assuming after hcg), and progesterone cream applied to the back of the neck/spine area. He posted in a youtube comment on a PFS video.
 
Any thoughts on why to improve fertility various studies shared on this site are having patients use much larger doses of hcg such as 1500iu 3x a week?
 
What a great thread. Just read all from the beginning. One thing I didn't see mentioned is the relation between Hct and HCG. Does the use of HCG and its dosage have any negative impact on Hct levels?
 
 
Dr. Saya - Thanks so much for this post. These results seem to mirror my results when changing hCG dose. I initially used 500iu twice per week. However, by day three I noticed a definite diminished effect on how I felt, and testicular volume. I tried changing to daily injections of 150iu, thinking that would work much better, but that quickly lost its effect. I might feel a little effect for a few hours, but after a couple weeks my testicles steadily got smaller, and the effects were almost nonexistent. I changed a few months ago to 350iu every M/W/F, which seemed to get better, but then I still felt very diminished effects by Monday morning. I recently switched to 350iu every M/W/F, with an additional 200iu "bump" on Sunday morning, which seems to be working much better for me at the moment.

I am a Defy patient, and am extremely primary. Before starting TRT my FSH/LH were very high, with a testosterone level of only 180. I'm starting to believe that the level of being primary hypogonadal plays a very big role in the effectiveness of hCG dosing amounts and injection schedule. To be honest, I would probably feel a lot better if my hCG dosing levels would mirror my pre-TRT LH levels (pretty high), but I try to stay pretty close to what I'm being prescribed.

@Dr Justin Saya MD @Nelson Vergel any news on the curves for serum hcg on the 250 and 350 doses?
 
Quick question,

what do you think the concentration curve looks like with 250iu of hcg daily vs 500iu hcg eod?

has anyone ever heard of 250iu+ used daily?

@Nelson Vergel @Dr Justin Saya MD @Cataceous
This is a very late reply, but I’ve done a lot of experimentation with different HCG doses over the past months and years. I’ve used both of those doses and more while on HRT in pursuit of dealing with PFS.

With 100-140iu’s daily for years, my testes were fine and I did receive some benefits from it. I seemingly received more benefits from the same doses broken up into fewer injections 3x a week. From there, I’ve tried 350-400 3x a week, 250-333 every day or 5x a week, 750ish 3x a week, and other variations.

At all doses, I didn’t notice any substantive impact on my E2 in blood tests. My E2 was almost always fine. The only thing I’ve ever done that truly diminished my sperm quality was trying to use AI’s at .5-1mg a week. At least in my case, E2 leads to thicker and more volumes of sperm.

For me personally, I have become a believer in there being a peak threshold needed to maximize the benefits of HCG, which will tend to mean higher doses 2-4x a week. The general consensus around here is that desensitization is not an issue at the kinds of doses most people would use, well under 5000iu’s a week. Benefits go beyond the first day as well, potentially being even higher on the second day based on the charts from Dr. Saya on peak concentrations, and I’ve heard elsewhere that some benefits linger on for up to 5 days from injection due to the downstream things HCG leads to. Some of those can be maxed out though, more HCG not being better in some cases.

A lot of the desensitization people talk about may come from higher E2 leading to a negative feedback loop when it comes to making more test when injecting HCG on top of that, which would seemingly go away if you stopped using as much if you were using it to increase testosterone. I’m not. I’m using it for everything else, and it seemingly works well to that end. By testes always seem fine while on HCG, unless it’s cold. I was actually worrying I’d desensitized myself until I realized winter’s merely coming.
 
This is a very late reply, but I’ve done a lot of experimentation with different HCG doses over the past months and years. I’ve used both of those doses and more while on HRT in pursuit of dealing with PFS.

With 100-140iu’s daily for years, my testes were fine and I did receive some benefits from it. I seemingly received more benefits from the same doses broken up into fewer injections 3x a week. From there, I’ve tried 350-400 3x a week, 250-333 every day or 5x a week, 750ish 3x a week, and other variations.

At all doses, I didn’t notice any substantive impact on my E2 in blood tests. My E2 was almost always fine. The only thing I’ve ever done that truly diminished my sperm quality was trying to use AI’s at .5-1mg a week. At least in my case, E2 leads to thicker and more volumes of sperm.

For me personally, I have become a believer in there being a peak threshold needed to maximize the benefits of HCG, which will tend to mean higher doses 2-4x a week. The general consensus around here is that desensitization is not an issue at the kinds of doses most people would use, well under 5000iu’s a week. Benefits go beyond the first day as well, potentially being even higher on the second day based on the charts from Dr. Saya on peak concentrations, and I’ve heard elsewhere that some benefits linger on for up to 5 days from injection due to the downstream things HCG leads to. Some of those can be maxed out though, more HCG not being better in some cases.

A lot of the desensitization people talk about may come from higher E2 leading to a negative feedback loop when it comes to making more test when injecting HCG on top of that, which would seemingly go away if you stopped using as much if you were using it to increase testosterone. I’m not. I’m using it for everything else, and it seemingly works well to that end. By testes always seem fine while on HCG, unless it’s cold. I was actually worrying I’d desensitized myself until I realized winter’s merely coming.
So what’s your opinion on the optimal HCG dose when used alongside testosterone injections?
 
Beyond Testosterone Book by Nelson Vergel
So what’s your opinion on the optimal HCG dose when used alongside testosterone injections?
It depends on why someone’s using it. If you’re just trying to maintain testicular function for the purposes of fertility and to prevent atrophy if you ever decided to quit TRT, you don’t seem to need that much. 250-500iu’s a week split up into at least 2 injections seems fine for that. You can always do more later if you’re trying to have kids and want to make it easier.

If you’re using HCG for the upstream hormonal benefits or to potentially deal with other issues like PFS, I’d recommend titrating up to the 1000-2500 iu’s a week range slowly over time, getting by with as little as you can until the benefits taper off. Minimum injections should probably be around 250-350iu’s each at 3-4x a week for that based on Dr Saya’s chart and my own personal experience, or 500iu’s EOD. I may even get more benefits from going a little higher but I don’t think I will because that’s really getting up there.

Most guys either feel way better from HCG, nothing, or way worse. I’d titrate HCG accordingly based on which you find yourself to be. Even if you don’t ever want kids, I wouldn’t necessarily recommend no HCG to somebody on TRT because keeping your testes functioning seems vital for a number of reasons far beyond fertility. Plenty of guys do it and say they’re fine, but I personally wouldn’t.

If you’re not on TRT and are using HCG for PFS or other reasons, you seem to be able to get by with less since test raises your usage and requirements of a lot of things, as do thyroid hormones.
 
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