LowT Mike, please share your knowledge on HCG...

[HRTstudent]

I saw this post from a thread just now, and rather than take that subject off-topic, I figured it would be appropriate to start a separate thread.

The post was from http://forums.steroid.com/hormone-re...cribe-hcg.html

[...] Sorry your doctor isnt educated on the use of HCG. There is so many double blind placebo resitant studies out there that show beyond a shadow of a doubt its importance and effectiveness of HCG with your TRT protocol. It comes down to doctors apathy to educate themselves and pick up a journal every now and then and educate themselves.

I would like to see the studies you are referring to that talk about the importance of HCG with TRT. I certainly don't doubt the efficacy of HCG to increase testosterone or promote spermatogenesis. But I've never seen any good science advocating it's use alongside TRT unless it was to maintain or promote fertility.

Looking forward to hearing more, thanks.

[LowT Mike]

Therapy with human chorionic gonadotrophin alon... [Int J Androl. 1992] - PubMed - NCBI

[LowT Mike]

Heres another study supporting HCG and spermogenisis production while on TRT. Whether on or off TRT the use and effects of HCG is the same. Ive had many patients some on TRT alone for almost a decade with azoospermia (undetectable sperm count). Some of these men decided to have kids later in life...some got divorced and remarried and decided to have kids again. In the high majority of these patients est 95% HCG administration jumpstarted there spermogenisis even after many years of TRT alone. It just works... if all your equipment works and there is no other underlining pathology for low sperm count HCG will work in this arena.

Concomitant IM HCG preserves spermatogenesis in men undergoing TRT

[APIs]

That's amazing info & a legitimate fear (maintaining fertility) for many men while considering TRT...

[KOArtist]

Mike, on that first one, any idea what kind of protocol (amount/frequency) they used?

[powerlifterty16]

Heres another study supporting HCG and spermogenisis production while on TRT. Whether on or off TRT the use and effects of HCG is the same. Ive had many patients some on TRT alone for almost a decade with azoospermia (undetectable sperm count). Some of these men decided to have kids later in life...some got divorced and remarried and decided to have kids again. In the high majority of these patients est 95% HCG administration jumpstarted there spermogenisis even after many years of TRT alone. It just works... if all your equipment works and there is no other underlining pathology for low sperm count HCG will work in this arena.

Concomitant IM HCG preserves spermatogenesis in men undergoing TRT

thanks for the studies low t mike! I had a question myself. as you recall, im on my 6 week restart of hcg. My restart ends on the 15th of july. I was wondering what day would be best to get a baseline blood test? I was thinking the 18th? Also what day should i go for a followup test to make sure my levels havent decreased. Thanks for the help bro

[LowT Mike]

Mike, on that first one, any idea what kind of protocol (amount/frequency) they used?

No sure on frequency with these studies...But my own studies with patient data and other collegues studies suggest complete leydig cell saturation with 250-500IU HCG 2-3x per week. Its not one size fits all. As barbaric of a triage as it is best way to stage effectivenes is to monitor testical size. Average testicle size 2.5cm-5cm. So monitor yourself and go for optimal fullness. Good sign that testes are rolling just fine.

[FRDave]

No sure on frequency with these studies...But my own studies with patient data and other collegues studies suggest complete leydig cell saturation with 250-500IU HCG 2-3x per week. Its not one size fits all. As barbaric of a triage as it is best way to stage effectivenes is to monitor testical size. Average testicle size 2.5cm-5cm. So monitor yourself and go for optimal fullness. Good sign that testes are rolling just fine.

How does one go about accurately measuring testicle size?

For convenience sake, if I were to go back to injecting HCG twice a week vs 3 times per week, do you recommend a certain day in relation to test injection like the day before?

Also, do you think there would be much concern in elevated E2 levels injecting 250iu 3x a week vs say 375-400iu or even 500iu twice a week?

[kelkel]

No sure on frequency with these studies...But my own studies with patient data and other collegues studies suggest complete leydig cell saturation with 250-500IU HCG 2-3x per week. Its not one size fits all. As barbaric of a triage as it is best way to stage effectivenes is to monitor testical size. Average testicle size 2.5cm-5cm. So monitor yourself and go for optimal fullness. Good sign that testes are rolling just fine.

Who's measuring? Better be a warm day.....

[LowT Mike]

HAHA. I know its sort of a funny subject measuring girth of testes. Its really just a rough estimate. But a great tool. In med school when your learning how to properly do s physical and asses genitourinary system (testes). Using your middle an index finger is just shy of 3 cm. So with the support of your thumb you can do this with ease. The fingers are really there just for a reference point. But you will be able to tell if your boys are atrophying or not. TRT alone with no HCG you generally can have a 20-50% atrophy. AND NO I WILL NOT MAKE A CRISLER VIDEO DEMONSTRATING THIS TECHNIQUE. LOL

My philosophy on day of the week to inject HCG only depends on the protocol im using on patient and protocol only depends on lifestyle and what the patient is going to be compliant with.

Protocol 1) If a patient is doing 1x per week injection of T, a good tip is to inject 250IU on day 4 and on day 5. This will give him a natural endogenous bump in serum T. Remember T cyp and E both peak serum T in 36-48 hours and then levels start going back to baseline. So a little bump in Serum T on day 4 and day 5 goes a long way to keep your level homeostatic and in the high 1/3 of top range throughout the week.

Protocol 2) Patient is administering T 2x per week. Mon/Thurs. With this protocol serum level T will stay in the top 1/3 of range throughout the whole week so using the above method of HCG on day 4 and 5 is irrelevant. I dont pay to much attention to timing of HCG with this protocol. HCG use following this method of TRT your just going for spermatogenesis and HPTA axis production. Generally an injection of HCG every 3 days is sufficient using this . I wouldnt slice it and dice your timing to much. Even doing 1 time per week injection of T its perfectly fine to admin HCG every 3 days. Just depends on your symptoms and if you feel the rollarcoaster of serum T going up (feeling great the first 3 days) then serum T falling and a crash at day 5-7. My 2 cents. Hope this all makes sense.

[kelkel]

HAHA. I know its sort of a funny subject measuring girth of testes. Its really just a rough estimate. But a great tool. In med school when your learning how to properly do s physical and asses genitourinary system (testes). Using your middle an index finger is just shy of 3 cm. So with the support of your thumb you can do this with ease. The fingers are really there just for a reference point. But you will be able to tell if your boys are atrophying or not. TRT alone with no HCG you generally can have a 20-50% atrophy. AND NO I WILL NOT MAKE A CRISLER VIDEO DEMONSTRATING THIS TECHNIQUE. LOL

My philosophy on day of the week to inject HCG only depends on the protocol im using on patient and protocol only depends on lifestyle and what the patient is going to be compliant with.

Protocol 1) If a patient is doing 1x per week injection of T, a good tip is to inject 250IU on day 4 and on day 5. This will give him a natural endogenous bump in serum T. Remember T cyp and E both peak serum T in 36-48 hours and then levels start going back to baseline. So a little bump in Serum T on day 4 and day 5 goes a long way to keep your level homeostatic and in the high 1/3 of top range throughout the week.

Protocol 2) Patient is administering T 2x per week. Mon/Thurs. With this protocol serum level T will stay in the top 1/3 of range throughout the whole week so using the above method of HCG on day 4 and 5 is irrelevant. I dont pay to much attention to timing of HCG with this protocol. HCG use following this method of TRT your just going for spermatogenesis and HPTA axis production. Generally an injection of HCG every 3 days is sufficient using this . I wouldnt slice it and dice your timing to much. Even doing 1 time per week injection of T its perfectly fine to admin HCG every 3 days. Just depends on your symptoms and if you feel the rollarcoaster of serum T going up (feeling great the first 3 days) then serum T falling and a crash at day 5-7. My 2 cents. Hope this all makes sense.

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[powerlifterty16]

thanks for the studies low t mike! I had a question myself. as you recall, im on my 6 week restart of hcg. My restart ends on the 15th of july. I was wondering what day would be best to get a baseline blood test? I was thinking the 18th? Also what day should i go for a followup test to make sure my levels havent decreased. Thanks for the help bro

alright ill just have to guess since my dr wouldnt advice me the proper time and mike wouldnt

[FRDave]

alright ill just have to guess since my dr wouldnt advice me the proper time and mike wouldnt

Something like 5-7 days after your last injection then 4-6 weeks later should be sufficient.

[LowT Mike]

youtube cricket sounds - Bing Videos

LOL. Bueller...Bueller

[LowT Mike]

alright ill just have to guess since my dr wouldnt advice me the proper time and mike wouldnt

Sorry powerlifterty16 didnt see you there. My recommendation is to do your blood test 24-48 after the last shot. The sooner the better considering the short biological half-life of HCG and FRDAVE is correct on follow up... 4-6 weeks after that.

[powerlifterty16]

Sorry powerlifterty16 didnt see you there. My recommendation is to do your blood test 24-48 after the last shot. The sooner the better considering the short biological half-life of HCG and FRDAVE is correct on follow up... 4-6 weeks after that.

thanks for the reply mike! I was under the assumption it would be best to wait 3-4 days to get the hcg out of my system, as opposed to doing th test when the hcg is in(since my goal is to restart and after 6 weeks i come off)...any reason why 24-48 hours is preferred man?


regarding followup...thanks. Im actually seeing a new endo on monday, so ill ask him if he could write a script for august...and get followup labs around the 15th.

[LowT Mike]

Its best to get labs tested 3 days after shot of testosterone due to the biological half-life. HCG has a much shorten active half-life so its best to test earlier. No need to "get it out of your system".

[kelkel]

Mike, to keep this going..

What is your philosophy on the cessation of HCG the week prior to BW to determine an actual test level sans HCG?
Some top doc's are preaching this.

[LowT Mike]

This might also be what powerlifty was thinking as well. Let me clarify. My thoughts are the same. If you were doing a HPTA restart and want to see if the HCG has helped you "recover" or you want "baseline T" after HCG therapy. Then you should wait around a week to get a true baseline of T levels. If you want to see how high is HCG getting my serum T levels then get labs no more than 48 after last shot.

[Rusty11]

Great question, kel. I had wanted to ask this.
Thanks for the info, LowT Mike.

[powerlifterty16]

This might also be what powerlifty was thinking as well. Let me clarify. My thoughts are the same. If you were doing a HPTA restart and want to see if the HCG has helped you "recover" or you want "baseline T" after HCG therapy. Then you should wait around a week to get a true baseline of T levels. If you want to see how high is HCG getting my serum T levels then get labs no more than 48 after last shot.

thanks for the reply again, idk if you remember but im just taking the hcg for 6 weeks to see if i can restart my hpta. i have never taken trt before. So i guess if my last shot is the 15th, then i should get the blood drawn around the 22nd?

im actually really scared to come off the hcg in case im lh suppressed

[powerlifterty16]

prolly gonna do it the 19-22

[100%]

Concomitant intramuscular human chorionic gonadotropi... [J Urol. 2013] - PubMed - NCBI