Leydig Cell Desensitization, E2, and hCG

[ZenFitness]

Since I am just now starting hCG, I'm curious about Leydig cell desensitization. My doctor wants me to do 250 IUs every day of hCG, but I told her that was too much and I'd rather do 3X a week 250 IUs (which she is fine with). I did start this week (my first week on hCG) with 250 IUs every day and will switch to 3X a week next week or perhaps 100 IUs every day.

My question is this - at what dosage does hCG potentially start to cause Leydig cell desensitization, what exactly is Leydig cell desensitization, and how influential is hCG on E2? I know high doses can cause E2 to rise, but I'm curious what the threshold is (typically, of course... everyone is going to be different).

[100%]

Dr. Scalley wrote:


"For example, there is absolutely no support for the following statement. I challenge anyone to find support.

"It is important that no more than 500IU of HCG be administered on any given day. There is only just so much stimulation possible, and exceeding that not only is wasteful, doing so has important negative consequences. Higher doses overly stimulate testicular aromatase, which inappropriately raises estrogen levels, and brings on the detrimental effects of same. It also causes Leydig cell desentization to LH, and we are therefore inducing primary hypogonadism while perhaps treating secondary hypogonadism. 250IU QD is an effective, and safe, dose. After all, we are merely replacing that which is lost to inhibition.""

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What about this, which suggests HCG induced desensitization can occur:

Effect of an antiestrogen on the testicular response to acute and chronic administration of hcg in normal and hypogonadotropic hypogonadic men: Tamoxifen and testicular response to hcg.

Levalle OA, Suescun MO, Fiszlejder L, Aszpis S, Charreau E, Guitelman A, Calandra R.

Division Endocrinologia, Hospital Carlos Durand, Instituto de Biologia y Medicina Experimental, Buenos Aires, Argentina.

The effect of the antiestrogen Tamoxifen (Tx) on the acute and chronic hcg administration was evaluated in patients with hypogonadotropic hypogonadism (HH) and in normal men. An hcg test (5000 IU hcg) was performed before, after two months of hcg administration (2000 IU hcg three times weekly) and after two months of hcg + Tx (2000 IU hcg three times weekly plus 20 mg/day of Tamoxifen). Blood samples were obtained before and following 24 and 72 h of every test to determine T, E, 17OHP and sex hormone binding globulin .

T increased only in HH with both treatments (X +/- SEM: Basal: 97.9 +/- 19.7; hcg: 237.7 +/- 43.2; hcg +/- Tx: 204.7 +/- 10.7 ng/100 ml).

17OHP rose with hcg alone, but not with hcg + Tx in both groups.

E, sex hormone binding globulin and 17OHP/T ratio did not change after treatments.

hcg tests:

E increased 24 h following hcg administration in every test. The ratio 17OHP/T rose at 24 h in the first and second test but in the third test it did not change.

These results support the role of E ]in the acute hcg-induced Leydig cell desensitization. However, the association of Tx does not improve T serum levels, suggesting that E might not be the unique factor involved in the mechanisms for testicular desensitization.

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And this, which suggests a dose of 250 - 350 iu is appropriate:

Title: Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression
Author: Yan, Xiaohua; Herbst, Karen L.; Sutton, Paul R.; Bremner, William J.; Wright, William W.; Anawalt, Bradley D.; Amory, John K.; Brown, Terry R.; Jarow, Jonathan P.; Zirkin, Barry R.; Coviello, Andrea D.; Matsumoto, Alvin M.
Abstract: In previous studies of testicular biopsy tissue from healthy men, intratesticular testosterone (ITT) has been shown to be much higher than serum testosterone (T), suggesting that high ITT is needed relative to serum T for normal spermatogenesis in men. However, the quantitative relationship between ITT and spermatogenesis is not known. To begin to address this issue experimentally, we determined the dose-response relationship between human chorionic gonadotropin (hCG) and ITT to ascertain the minimum dose needed to maintain ITT in the normal range. Twenty-nine men with normal reproductive physiology were randomized to receive 200 mg T enanthate weekly in combination with either saline placebo or 125, 250, or 500 IU hCG every other day for 3 wk. ITT was assessed in testicular fluid obtained by percutaneous fine needle aspiration at baseline and at the end of treatment. Baseline serum T (14.1 nmol/liter) was 1.2% of ITT (1174 nmol/liter). LH and FSH were profoundly suppressed to 5% and 3% of baseline, respectively, and ITT was suppressed by 94% (1234 to 72 nmol/liter) in the T enanthate/placebo group. ITT increased linearly with increasing hCG dose (P < 0.001). Posttreatment ITT was 25% less than baseline in the 125 IU hCG group, 7% less than baseline in the 250 IU hCG group, and 26% greater than baseline in the 500 IU hCG group. These results demonstrate that relatively low dose hCG maintains ITT within the normal range in healthy men with gonadotropin suppression. Extensions of this study will allow determination of the ITT concentration threshold required to maintain spermatogenesis in man.
URI: Page not found
Date: 2005-05

https://digital.lib.washington.edu/d...ndle/1773/4415

Highly debated subject

[Faster]

Can your body recover from a total Leydig cell desensitization shutdown?

[booku]

has anyone experienced this so called desensitization to 'LH analog/hCG' by the leydig cells at the recommended dose of say 250 IU 3 days per week?

What exactly happens if it did occur?

[powerlifterty16]

has anyone experienced this so called desensitization to 'LH analog/hCG' by the leydig cells at the recommended dose of say 250 IU 3 days per week?

What exactly happens if it did occur?

so since im doing monotherapy, if my doc gives me 250-400 3x per week i should be in good hands? Im not using an ai, for my 6 week protocol.

[booku]

so since im doing monotherapy, if my doc gives me 250-400 3x per week i should be in good hands? Im not using an ai, for my 6 week protocol.

hCG monotherapy is rarely effective IMO for this very reason, desensitization, E2 problems, never can get TEST levels high enough etc

So my first question would be why monotherapy if you are in this for the long haul? you are just delaying the inevitable IMO

[100%]

hCG monotherapy is rarely effective IMO for this very reason, desensitization, E2 problems, never can get TEST levels high enough etc

So my first question would be why monotherapy if you are in this for the long haul? you are just delaying the inevitable IMO

This is highly debated. DR. Scally does not believe that desensitization occurs a dose up to 5000iu.

[Faster]

When desensitization occurs the persons testicles usual shrink and stop working

[kelkel]

There's no magic number. All are different. Remember Scally's power pct protocol calls for 2000 IU's HCG EOD for 10 total injections or so. A bit of a contrast. In other words, you'll be just fine at the amount your doing.

[powerlifterty16]

doc didnt wan to give me trt because im 23....and we have done tests to find out why my test is low, and a lot came back negative, so now we are trying to raise it.

hCG monotherapy is rarely effective IMO for this very reason, desensitization, E2 problems, never can get TEST levels high enough etc

So my first question would be why monotherapy if you are in this for the long haul? you are just delaying the inevitable IMO

[Faster]

You can re sensitize desensitized Leydig cell desensitization and LH with a longer stent of clomid and nolvadex It takes a while but it can be done.

[david.richard]

Hi Faster,
After a long term use of AAS i got severe Oligospermia and after doing some research on internet i found following article and i thought i should give it a try

(For article search this keyword in google "Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin")

Before starting the procedure my total testosterone was normal it was around 550 ng/dl, when i start the treatment with 10000 IU HCG twice a week and HMG 75 IU daily the T level shoots up to 800 ng/dl but at the end of second month my T level start declining and in third month with same dose of HCG they drop down to 400 ng/dl. Now its almost 4 months i completed the treatment and my T levels are 200 ng/dl, LH is 5.5 and E2 is low than normal, it seems leydig cells got desensitize due to high dose of HCG.

Please let me know the dosage of clomid and nolvadex to recover it

[Mr.BB]

This thread is from 2013, you are not going to get any answers from those guys, as they almost all gone.

Seems you didnt got the best treatment there, HCG is supressive and that dosage is crazy, do clomid and nolva for 4 weeks:

week 1 - 75mg Clomid; 40 nolva
week 2, 3, 4 - 50mg Clomid; 20 nolva

BTW, welcome... stick around, plenty of info here, if you had us posted that procedure most of us would have advised against it.

EDIT: Clomid and nolva have a long half life, so its only advised to take bloodwork to check if it worked 6-8 weeks after. During treatment it is likely your test will come up following the high LH.

[david.richard]

Hello BB,
Four weeks on Nolva 20mg and Clomid 50mg result T 24.97 nmol/L reference range 5.7 - 28.14 than four weeks off and again i started 25mg clomid a day (half tablet) and added multivitamins for one month and result 28.
Before starting HCG i used clomid 25mg for three months and that time T peaked at 22