T Nation

10,000 IU of HcG per Week?


#1

Hi there,
My doc recently gave me a 'script for 10,000 IU of HcG per WEEK. He said that I could possibly start at 5,000 IU and see how it goes, then ramp up to 10,000 if needed.

A little history: I've been seeing this doc, who is a urologist who started up his own TRT / male health practice. He's been doing this for quite a long time. Here is what I've been through since starting with him:

When I first came in, my initial blood test showed a total testosterone level of 210 -- way low for my 50-55 yr age range, which according to him should be 365 at the low end with a median around 491, assuming no therapy and normal decreases with aging. My LH level was 5.0.

I've been on Clomid, 25mg / day since July. My last blood test showed a T level of 368, with an LH level of 7.5. So, not a lot of improvement.

He has diagnosed me with secondary hypogonadism. Now he gave me two new options:

  1. TRT .5 to .7 ml / week with 2,000 IU of HcG to supplement.
  2. 10,000 IU of HcG per week, along with an AI (anastrazole).

He insists that the risk of "burning out your Leydig cells" (desensitizing them) is a myth with no reputable medical study to back it up. He says that there is no risk in 10,000 IU a week. I would like to know your take on that.

I'm not even sure if I can afford that. HcG is expensive. I found a site, SafeMeds4All, that looks somewhat promising, but would like to know where you guys get your HcG. Also, in what format. It looks to me that the freeze-dried form which I would have to reconstitute seems like the best choice as far as buying in bulk and making sure the shelf life is good.

I am not a bodybuilder and probably need to exercise more. (I do P90X but have fallen off the track of doing it religiously. I also hike pretty often.) I know nothing about PCT and cycling and all that. I'm just a 50+ year old guy looking for some advice on a long-term solution to my problem.

Thanks for reading and for your input.


#2

10,000iu/wk is an insanely high dose, even 5,000iu/wk is very high.

What is his reasoning behind such large doses? What's the benefit?

I've never heard of any doctor prescribing 10,000iu/wk before, I'm assuming that there is a reason for that.


#3

Doc=Idiot.

You have to manage your own health care because you can't trust the loonies with MD degrees in many cases. Start by reading the stickies here [there are 7] and begin with advice for new guys.

High hCG promotes high T-->E2 inside the testes and anastrozole cannot control that, do doc is wrong again.

At your age, go for the protocol suggested here:
100mg T per week, inject 50mg twice a week [use mg's not ml's, not all injectable T is the same]
1mg anastrozole per week, take 0.5mg when you inject T
250iu hCG SC EOD [is all that you need, 10,000iu lasts 80 days]

You build up your T levels with [self] injected T as that is very cost effective. hCG is to preserve your testes and for some mood support. hCG 250iu SC EOD may increase T 10-20%.

Do these labs:
CBC
hematocrit
TT
FT
E2
PSA
TSH
fT3
fT4

You should have a DRE before starting TRT and then 6-12 months later and once per year after.

Post your labs with ranges. Any other health concerns?


#4

KSMan - Thank you very much for your reply...and Happy New Year!

I've just started getting reviewing the stickies again. I did post once before here, last year, but started this new thread because, well, the old post just had a lot of stuff in it that doesn't apply anymore and hasn't for quite a while, and really, this is essentially a brand new start with different parameters.

Anyhow...I think your protocol looks good. I am interested in the subcutaneous method of T injection, as everything I'd seen up to now (and what the doctor says) is that it is injected intramuscular with a pretty big needle. He also has the schedule at once/week, and I think that if I can inject using the same type of insulin needles that I will use for HcG injections, and do that more than once a week to avoid the swings in peaks/troughs, I'd be a lot happier.

I didn't see DRE as a listed acronym in the newbie's guide. What is that?

I am about 99.9% sure that I have done all of the blood tests that you listed. My doc carries around an iPad that has all of that, and I've looked over his shoulder as he's shown me at least some of the results. I'll see if I can get a good printout of the most recent test and post that here. All I know from that so far is what I posted: LH at 7.5, total T at 368.

No other health concerns other than some IBS problems that I manage well with diet, probiotics and Protonix.

From what I gather in talking with the doc, he seems to think that that 10,000 IU weekly dose is what is needed if using HcG exclusively to keep an optimal level of T at my age / with my hypogonadism condition. It seemed pretty extreme to me when I heard that, so wanted to check here.

I was intrigued by the HcG-only method because it seems a more natural, less risky method of increasing T by letting my own body do it, rather than just injecting exogenous T into my body. Is an HcG-only method something that is, shall I say, frowned upon here, then? Just interested for my own edification.

Thanks again.


#5

Oh, also, sorry about asking where people get HcG here. I saw now that that is a no-no. I was just really interested in finding a reputable source, that's all. I can get it from the doc, but it's pretty darn expensive and I was looking for a more affordable source.


#6

OK, DRE = Digital Rectal Examination.
Yep, gotta love those. :-\


#7

Sorry for the multiple reply posts, but I just had a thought:
You said that HcG 250IU EOD may increase T 10-20% on its own.
Since I'm at a level 368 and optimally should be nearly twice that, then I would need a 200% increase in T, or ten times the 250IU EOD amount. So maybe the doc did that math and ended up with 2500 IU four times a week (roughly EOD) to arrive at 10,000 IU per week.


#8

How did your doctor diagnose you as secondary with just an LH value of 5.0? Maybe I'm missing something?

HCG monotherapy is certainly an option for those who are secondary, but at your age I wouldn't hold your breath for any sort of restart attempt actually working.

10,000iu is an insane dose. You're not going to be able to control E2 on that dose, and since nobody ever takes doses like that, nobody knows what other negative effects it could have on you.


#9

Honestly, I am going to have to ask him more about how he made that diagnosis. I need to ask him a lot of questions, actually -- or maybe not so much ask questions as tell him what protocol I would like to do and then see how he responds. His response will say a lot about whether I should continue with this guy or not.


#10

So, I proposed KSMan's protocol to my doc. He recommended upping the hCG dosage to 500iu EOD (from 250iu EOD), citing that as the recommended dosage to counteract the effect of T on my testicles. The rest of the regimen, he is OK with.

As far as the blood testing, he doesn't do the thyroid tests for T3 or T4, saying that he doesn't feel the need for those. Wondering if he's right on that. Just how important in the scheme of things are those tests?


#11

Thyroid: Read the thyroid basics sticky and get up to speed on iodine and body temperature issues. If body temps are low, thyroid function is low. IR can fix ID.


#12

Can anyone comment on the increasing of snoring while on TRT? Up until the past few month, the only time I have ever snored was when I was sick with a head cold or something that involved sinuses, or when extremely tired. I currently am not sick and not tired but my snoring is so bad that the wife got up and slept on the couch last night. This is the worst side effect I could possibly think of.


#13

Start your own thread.


#14

I do apologize. I thought I was in mine. I clicked on the wrong thread.


#15

Thanks for that reply, KSMan.

Well, I told my doc that I will be purchasing my Arimidex (generic) and hCG from a different source. Way cheaper than his prices. The T, I will be getting from him.

Just wondering: This source has hCG injectable liquid (already reconstituted), and freeze-dried hCG powder. Do you guys generally recommend buying in liquid or powder form? Do you have any specific protocol for reconstitution of the powder (bac. water ratio to hCG IU, etc.)?


#16

I'm also a bit confused about how to reconcile what I read here about iodine supplementation (12.5 mg a day seems to be popular), with what I read on medical sites like WebMD, which state that anything over 1,100 mcg a day (that's only 1.1 mg) can be dangerous and can cause multiple thyroid issues.

So what is the story on that?

Thanks.


#17

^ Bump?


#18

Get the powder if this is being shipped to you. Once reconstituted to liquid form, HCG must be kept refrigerated or it goes off quickly. (I am doubtful of the claims that that particular brand is stable at room temperature, given that it is the same molecule.) With shipping from the usual sources (normally countries in the tropics), there is in any case a large risk of exposure to high (much more than room-) temperatures along the way.

Even having the powder shipped makes me nervous, although I do that myself due to high cost in the U.S.

You can reconstitute with less water, but a good rule of thumb is to add 1 ml bac water for each 1,000 IU HCG in the vial. Then your dose of 500 IU HCG would be 50 units on an insulin syringe.


#19

Great, thank you very much for the reply.

I guess I'll just have to trust that the powdered form doesn't break down in shipment. It's too bad this stuff costs so much in the US; hopefully the price will come down eventually, but I'm not holding my breath.


#20

I read somewhere that it will last longer if you use less BAC water. I use 2ml for 5000IU. That gives me 250IU by drawing to the 10 mark,