
Originally Posted by
Youthful55guy
It's highly unusual to prescribe HMG for a TRT monotherapy. Commercial HMG is essentially purified FSH, a hormone with no ability to stimulate T production, has a relatively short half life, and is extremely expensive.
Some docs prescribe HCG as a monotherapy. HCG at doses approaching 1000 IU per week may stimulate adequate T production is individuals with secondary hypogonadism, but it is a very expensive form of TRT therapy and the outcomes are generally disappointing in terms of T levels. Also keep in mind that both HMG and HCG will feedback negatively on the hypothalamus and pituitary to decrease endogenous secretion of T, so you probably will not be any further ahead then without it.
I suggest you read the first sticky on the front page of the forum for best practices in TRT. Many of your questions will be answered there.
Regarding IGF-1 (the original question), there is definitely an interaction between T levels, E levels, and IGF-1 levels. You need normal E levels to stimulate production of endogenous GHRF (the releasing hormone for GH). GH stimulates the production of IGF-1. Since E is made from T, lowish T levels will mean lowish E levels, which in turn will result in lowish IGF-1 levels. Bottom line, straighten out T levels with a well thought out protocol and IGF-1 levels should increase.