TRT without hcg.

[hammerheart]

Those doses are intended for women, I don't understand what your talking about. I guess the clinical data available on HCG for men is scarce.

I'm not prone to placebo.

[FakeLove]

Well HCG has a biphasic pattern. It stimulates T initially and then the testes go into a refractory period, 72 hours later releasing more T from the same shot. So technically you could do once per week.

I am not sure the schedule matters but personally I am also not sure if less than 500IU in one dose does much to override suppression.

Let me know if that makes sense.

There's one study available that suggests that even 125IU every other day provides results statistically not significant compared to the baseline in context of suppression. Baseline was maintained at 250IU eod and it increased with 500IU eod. I know many examples who have restored fertility with 250IU eod protocol, but of course there must be individual variance in this.

For OP: I've had a stable testosterone only protocol for almost two years now, and now for fertility purposes added HCG with 125IU ed. It blew my estrogen production through the roof instantly. To maintain my optimal estrogen level with HCG I need a triple AI dosage compared to the testosterone alone. We've had a discussion of the topic on the other forum and it's quite clear that AI's aren't very efficient to control the increased estrogen production caused by HCG. So I'd say for some it just requires heavy AI dosages to keep estrogen in check to maintain a good mood and function. When I'm on top of the AI dosage I'm all good, but if I try to reduce hell breaks loose.

[InternalFire]

For this reason alone ^ Im gonna cut out my hcg out of trt to see how I do without it. I too experienced some e2 sides and I feel hcg is to blame

[IncreaseMyT]

Balducci R, Toscano V, Casilli D, Maroder M, Sciarra F, Boscherini B. Testicular responsiveness following chronic administration of hCG (1500 IU every six days) in untreated hypogonadotropic hypogonadism. Horm Metab Res 1987;19(5):216-21.

The observation that the testosterone (T) response to a single intramuscular injection of hCG is prolonged suggests that currently used regimens (2-3 injections per week) to stimulate endogenous androgen secretion in hypogonadotropic hypogonadism (HH) patients have to be reassessed. Moreover, during the last few years, Leydig cell steroidogenic desensitization has been found after massive doses of hCG. The aim of the present investigation, carried out in 6 HH patients who showed no signs of puberty, was to study the effect of 1500 IU hCG administered every six days over a period of one year to induce the onset of pubertal development. To evaluate the kinetics of the response of T, 17 alpha-hydroxyprogesterone (17 alpha-OHP) and 17 beta-oestradiol (E2), blood samples were taken basally and 1, 2, 4 and 6 days after drug injection. This dynamic study was performed after the first injection and after the 4th and 12th month of treatment. During this one year time period, a progressive increase in testicular size was observed. Comparing plasma T levels (mean +/- SE) before the first injection (11.2 +/- 4.7 ng/dl) with the corresponding values at the 4th (38.7 +/- 10.5 ng/dl) and 12th months (99.5 +/- 19.9 ng/dl) of therapy, a progressive and significant increase was observed. T reached a maximum elevation 58 hours after hCG injection at the 4th month (198.3 +/- 42 ng/dl; P less than 0.01) and at the 12th month (415.6 +/- 62.6 ng/dl; P less than 0.05), whereas it remained unchanged following the first hCG injection

D'Agata R, Vicari E, Aliffi A, Maugeri G, Mongiol A, Gulizia S. Testicular Responsiveness to Chronic Human Chorionic Gonadotropin Administration in Hypogonadotropic Hypogonadism. J Clin Endocrinol Metab 1982;55(1):76-80.

Steroidogenic responsiveness to long term hCG administration (1500 U three times a week for 23 months) was characterized in 8 males with hypogonadotropic hypogonadism (HH). During hCG treatment, testosterone (T), which was in the prepuberal range under basal conditions, rose considerably to the upper end of the normal range and remained at that level during the 23 months of observation. A 2.5-fold increase was observed in serum levels of 17{beta}-estradiol (E2) an increment less than seen with T. The increment in 17{alpha}-hydroxyprogesterone was also lower than that in T throughout the study; thus, the 17{alpha}-hydroxyprogesterone to T ratio, despite continuous hCG administration, remained low. Serum androstenedione was slightly increased during hCG therapy. No significant changes were observed in serum levels of dehydroepiandrosterone. These data indicate that continuous long term hCG administration stimulated T levels in HH, with a relatively small change in E2. The kinetics of the T and E2 responses to 2000 U hCG, evaluated after 23 months of therapy, indicated that the testicular response was markedly reduced. No increment in T levels was observed at 24 h; the maximal response occurred at 48 h. This pattern of T response supports the idea that partial testicular desensitization occurs in HH patients receiving chronic treatment with hCG.

I don't think there is a need for QD dosing, or even QOD. I also think the E2 side effects are really overblown.

250IU QOD may prevent full shut down, but I can assure you to regain function once it has been lost it is not nearly enough.

[krugerr]

Gotta say guys, this is another thread thats turned into a gem of information.
Some real quality knowledge being shared in the TRT forums of late.

[macmathews]

I don't think there is a need for QD dosing, or even QOD. I also think the E2 side effects are really overblown.

250IU QOD may prevent full shut down, but I can assure you to regain function once it has been lost it is not nearly enough.

What is QD - subcutaneous daily ?
What is QOD - subcutaneous every other day ?

And like any other side affect , everybody reacts and feels different
I felt shitty with an E2 of 80.. But I felt far worse with an E2 of 10..


Mac

[IncreaseMyT]

QD and QOD is just every day or every other day. Sorry sometimes I get in the habit.

For E2 sides, I don't mean symptoms are overblown, I agree E2 is the most important part of TRT for men (most don't realize this). I just meant I don't think HCG affects E2 like guys think it does.

Just my 2 cents

[kelkel]

I often recommend guys take a couple weeks off of HCG prior to BW to see exactly what levels are without it. Assuming an already stable protocol has been attained. It will answer your own questions.

[macmathews]

I often recommend guys take a couple weeks off of HCG prior to BW to see exactly what levels are without it. Assuming an already stable protocol has been attained. It will answer your own questions.

And why would you want to see levels without it when likely your test levels are lower without it ?
Am I correct in assuming that if my Free T is in the bottom of norm off TRT, using HCG while on TRT will boost my levels above injection only ?

Mac

[kelkel]

Then you can learn exactly what it does or does not do to your levels. Just another way to learn how "you" work.

[FakeLove]

QD and QOD is just every day or every other day. Sorry sometimes I get in the habit.

250IU QOD may prevent full shut down, but I can assure you to regain function once it has been lost it is not nearly enough.

Based on that small study 250IU eod prevented shut down fully, not just a full shut down. Have you tried 250IU eod protocol with your patients? There's probably very little comparable data available about regaining function with low dose ed/eod protocol. Also the study you quoted only tried 1500IU dose, but no comparison with low dose.

In my country we have quite an active trt board and there's people who have regained function with 250IU eod even after being 2 years or more on T only. Then there's also long term AAS users who have done the same. I personally will know how it ends up for me in three months latest. No worries if it will not, there's my valid stuff in the freezer too. I'm just willing to try.

We have also documented lots of significant E2 increases when HCG have been added. Now of course it doesn't affect everyone and about the statistical significance it's difficult to debate about when studies are quite limited in this context, but I personally needed to triple my AI dose to maintain same level of E2 versus T only. I'm not the only one for sure, but how many percentage of patients have it, who knows. My doc has 1000 patients and said that based on labs and how they felt majority of them needed to increase AI dose when HCG had been added. How much E2 increased among them only the doc knows and we all seem to respond individually, but that's my experience.

[IncreaseMyT]

Our clients are on a wide array of programs.

I would be curious to see the TT labs after two years of suppression, while on the HCG and see what TT levels are.

We have done over 200 restarts in the last 6 years.

In that study they merely measured function with sperm count I believe, and that really doesn't say much. Some men never lose fertility on T without HCG.

I never said HCG cannot stimulate E2 directly AND convert to E2 because it can do both.

I merely said it is very overblown and parroted on websites continuously and the truth is, out of 25 guys you ill be lucky to find one that spikes E2 with HCG.

Also the jump is not always a bad thing. E2 is a great hormone that we need.

Also the study was to prove that QOD simply is not needed and that even in dosages 8 times the dose your referring to, men did not have a large jump in E2.

Hope this makes sense.

[FakeLove]

Thanks, it makes sense. So you believe that regaining function wouldn't possible with 700IU per week and that it would need around 1500IU?

I understand that all me don't lose their fertility while on T (or gear), but I certainly did. After three weeks of T sperm count was zero. Though I don't exactly know was it T at the end or chemotherapy that did the trick since sperm count wasn't tested in between them.

[IncreaseMyT]

From what we have seen, 1k to 1500 IU 2-3 times per week works better, for severe shutdown.

750 three times per week does it sometimes.

Too often we have seen guys do 500 three times per week and come back in the 300's.

Its really hard to say though, just depends on the level of suppression and what "recovery" means to the person assessing.