No to HCG

**17chester6** · 11-29-2013, 05:50 PM

I started TRT today. In a nutshell I'm 58 and I had a full endocrine profile, blood count etc. (I have read the stickies and know what needed to be tested) and the findings were a very low Vitamin D (living in Canada can cause that!), low normal TT, subnormal FT, low E2 (less than 19 in USA units) elevated FSH/LH and low DHEAS. While the C reactive protein was great, my homocystine was hight normal. Diagnosis: primary hypogonadism. All the other parameters were excellent.

So I have started injections twice weekly of 50 mg T. cypionate and DHEA 50 mg daily orally. Plus I upped the Vitamin D to 5000 IU and started a B complex to help with the homocystine.

However it was suggested that I not start HCG as it will likely not work (it would be like flogging a dead horse as the FSH/LH are already elevated). Also as my E2 was so low no AI was prescribed. The plan is to reassess the blood profile in 3 months.

Any thoughts on the omission of HCG and an AI?

P.S. sticking that first needle in my thigh was scary...but painless ;-)

**bass** · 11-29-2013, 06:03 PM

sounds like your doc knows what he's doing. yes hCG won't do much since you're primary, however it has other benefits and its worth including it.

**EasyDoesIt** · 11-29-2013, 06:07 PM

Originally Posted by 17chester6

P.S. sticking that first needle in my thigh was scary...but painless ;-)

After awhile you will be looking forward to it!
Welcome to the forums.

**Beethoven** · 11-29-2013, 06:15 PM

Originally Posted by bass

sounds like your doc knows what he's doing. yes hCG won't do much since you're primary, however it has other benefits and its worth including it.

Yes, HCG has been a very welcome addition to my protocol. And as easydoesit said, you will start to look forward to it.

**kelkel** · 11-29-2013, 07:02 PM

How elevated were your LH/FSH and how low was your T levels? Ranges please if you can.
No need for the AI until BW is done. Which really should be in around 6 weeks.
If one is needed try DIM, zinc and copper first. Avoid adex, etc if possible.
Very impressed your doc is good with the twice per week injections. Nice!
Keep an eye (or someones anyway) on testicular size.

**Java Man** · 11-29-2013, 07:15 PM

FSH LH are high because your body is signaling T production. Since youre primary, that production line is not responding to orders. HCG is an LH mimic. When you're low on T but LH is not increasing, HCG fills that void. In your case, the problem is not the lh/fsh part of the loop. Your Dr. is right.

**dreadnok89** · 11-29-2013, 10:00 PM

Originally Posted by Java Man

FSH LH are high because your body is signaling T production. Since youre primary, that production line is not responding to orders. HCG is an LH mimic. When you're low on T but LH is not increasing, HCG fills that void. In your case, the problem is not the lh/fsh part of the loop. Your Dr. is right.

So there is no way to stop shrinkage?

**bass** · 11-29-2013, 11:19 PM

nope, only hCG can prevent it.

**61er** · 11-29-2013, 11:30 PM

Originally Posted by dreadnok89

So there is no way to stop shrinkage?

I'm primary, however HCG has been successful in reversing shrinkage. I suffered several rounds of "retractile testicle" (testes pulled back into scrotum) after a year on TRT. I assume that as the testes become smaller the cremaster muscle can more easily pull them up. While this is not a serious condition, I didn't like it one bit. (You have to basically push the testicle out from it's retracted position; I'm cringing and squeezing my legs together as I write this). Now that I'm on HCG, testes seem heavier and hang "just right". Here's where I'm confused: if HCG monotherapy does not trigger Leydig cells (to produce testosterone ), why do testes become fuller?

**Beethoven** · 11-30-2013, 09:09 AM

Yep, mine had started to shrink and were hurting some, too. HCG got them back to normal.

**17chester6** · 12-01-2013, 12:50 PM

Kelkel, you asked for lab values. They are in SI units.

FSH: 10 (2 -8 IU/L)
LH: 6 (2-6 IU/L)
TT: 12.9 (8.4-28.8 nmol/L)
FT: 20.5 (25-80 pmol/L)
E2: <70 (<150 pmol/L)
DHEA-S: 1.6 (<9.7umol/L)

I hear you on the first blood check being in six weeks and not three months. I will email the doc and request a requisition for just the TT, FT, E2, DHEA-S in six weeks and keep the three month requisition for the wider check of all the original parameters. The doc is very obliging and completely open to suggestions.

So again the issue of no HCG and no AI at this stage. Any further comments? Finally, you said I should avoid the AIs. Why so?

Thanks for the comments, they really has been helpful. Also, reading the stickies before seeing the doc made the visit so much more relevant as I knew what he was talking about and I could ask constructive questions.

**kelkel** · 12-01-2013, 04:29 PM

Originally Posted by 17chester6

Kelkel, you asked for lab values. They are in SI units.

FSH: 10 (2 -8 IU/L)
LH: 6 (2-6 IU/L)
TT: 12.9 (8.4-28.8 nmol/L)
FT: 20.5 (25-80 pmol/L)
E2: <70 (<150 pmol/L)
DHEA-S: 1.6 (<9.7umol/L)

I hear you on the first blood check being in six weeks and not three months. I will email the doc and request a requisition for just the TT, FT, E2, DHEA-S in six weeks and keep the three month requisition for the wider check of all the original parameters. The doc is very obliging and completely open to suggestions.
Take a look in the Finding A Doc sticky thread and obtain the second set of test within it, if possible.

So again the issue of no HCG and no AI at this stage. Any further comments? Finally, you said I should avoid the AIs. Why so?
Because more med's aren't better. Why take an AI if you don't have to? Especially with a twice per week protocol and supps such as DIM, Zinc and Copper to try first. Just a healthier alternative. Personally I would take the hcg if your doc prescribes it. It can only help. LH receptors are throughout your body, including your brain.

Thanks for the comments, they really has been helpful. Also, reading the stickies before seeing the doc made the visit so much more relevant as I knew what he was talking about and I could ask constructive questions.

Post up your doc follow up here please!
Look into supplementing with micronized pregnenolone and DHEA as well.. Slow-Release Micronized for both. Vit D as well. Know your level.

**Oki-Des** · 12-02-2013, 08:35 AM

I actually enjoy the shrinkage I knew I was getting old when I sat on the toilet and felt the shock of cold water on my balls! Ha ha. Yes, they actually touched the water. Now when they are smaller they dont hang so low and I may seem crazy, but it is one of the benefits in my opinion.

**Java Man** · 12-02-2013, 08:51 AM

Originally Posted by Old-Fart

I actually enjoy the shrinkage I knew I was getting old when I sat on the toilet and felt the shock of cold water on my balls! Ha ha. Yes, they actually touched the water. Now when they are smaller they dont hang so low and I may seem crazy, but it is one of the benefits in my opinion.

Ehhh TMI?

**trikydik** · 12-02-2013, 06:22 PM

hahahaha damn how small is your toilet???

**2Sox** · 12-02-2013, 07:31 PM

Originally Posted by trikydik

hahahaha damn how small is your toilet???

Or maybe the seat is too big? ;-)

**Trevtrev** · 12-02-2013, 07:57 PM

Originally Posted by kelkel

How elevated were your LH/FSH and how low was your T levels? Ranges please if you can.
No need for the AI until BW is done. Which really should be in around 6 weeks.
If one is needed try DIM, zinc and copper first. Avoid adex, etc if possible.
Very impressed your doc is good with the twice per week injections. Nice!
Keep an eye (or someones anyway) on testicular size.

What is the correct dosage and frequency of dim, zinc, copper?