T Nation

26 Y/O Starting HCG-Only, Good Idea?

Hello everyone. First time poster few week lurker.
I have been feeling not myself for about 5 years I would say since roughly 20-21 not sure what happened but I became depressed, had low libido, energy, etc since then. Haven’t really done anything about until about 6 months ago I went and got my hormones checked just to make sure nothing was weird.

6’1 about 200 pounds BF 21-23%
workout frequently recently haven’t had the energy so I go home and sit on the couch after sitting all day at work…
low libido and erections are decent but only when I am tired at night am I horny… not sure if this has something to do with the thyroid but… also I will wake up with high libido 1-2 hours into my sleep and it is fantastic let me tell you! lol TMI

First test: 6-7 months ago
Testosterone, Serum 323 ng/dL 264 - 916
Sex Horm Binding Glob, Serum 40.4 nmol/L 16.5 - 55.9

Second test: 3 months ago
Estradiol 21.8 pg/mL 7.6 - 42.6
Testosterone, Serum 475 ng/dL 264 - 916
Free Testosterone(Direct) 12.2 pg/mL 9.3 - 26.5
Sex Horm Binding Glob, Serum 44.2 nmol/L 16.5 - 55.9
Cholesterol, Total 157 mg/dL 100 - 199
Triglycerides 98 mg/dL 0 - 149
HDL Cholesterol 62 mg/dL >39
VLDL Cholesterol Cal 20 mg/dL 5 - 40
LDL Cholesterol Calc 75 mg/dL 0 - 99
TSH 3.050 uIU/mL 0.450 - 4.500
LH 6.2 mIU/mL 1.7 - 8.6
FSH 2.8 mIU/mL 1.5 - 12.4
Prolactin 19.4 High ng/mL 4.0 - 15.2
Fasting Glucose 117 High mg/dL 65 - 99
BUN 16 mg/dL 6 - 20
Creatinine 0.88 mg/dL 0.76 - 1.27
eGFR If NonAfricn Am 119 mL/min/1.73 >59
eGFR If Africn Am 138 mL/min/1.73 >59
BUN/Creatinine Ratio 18 9 - 20
Sodium 139 mmol/L 134 - 144
Potassium 4.0 mmol/L 3.5 - 5.2
Chloride 100 mmol/L 96 - 106
Carbon Dioxide, Total 23 mmol/L 20 - 29
Calcium 9.4 mg/dL 8.7 - 10.2
Protein, Total 7.1 g/dL 6.0 - 8.5
Albumin 4.8 g/dL 3.5 - 5.5
Globulin, Total 2.3 g/dL 1.5 - 4.5
A/G Ratio 2.1 1.2 - 2.2
Bilirubin, Total 0.5 mg/dL 0.0 - 1.2
Alkaline Phosphatase 66 IU/L 39 - 117
AST (SGOT) 20 IU/L 0 - 40 01
ALT (SGPT) 16 IU/L 0 - 44 01
Vitamin D, 25-Hydroxy 27.8 Low ng/mL 30.0 - 100.0

3rd test: one week ago over the phone numbers
Testosterone, Serum 476 ng/dL 264 - 916
Free Testosterone(Direct) 9 pg/mL 9.3 - 26.5
prolactin was 10

What is going on here? Clearly I have enough LH so why take more?
I am not understanding what is the problem as clearly the feedback loop isnt working.
I do have pain and dull ache from left testical there is no bag of worms however maybe low grade varicocele? Should I continue with HCG therapy? They are not willing to do TRT since I a so young but willing to start me on 250iu twice a week - which is weak…

Do I pay hefty amount for an ultrasound at a urologist just to find out that I might need surgery fix my levels just enough so I can’t get treatment?

Thanks guys. Thanks in advance!!!

This is the main problem, it’s the portion that is free in the blood and it is very low. HCG only stimulates half of the testclies while suppressing the other half, therefore doesn’t activate all hormonal pathways, there are a few who respond well. Good luck controlling estrogen produced inside the testicles with anastrozole, which doesn’t affect E2 inside the testicles.

Then fight back, simply leave and go somewhere else. Find a doctor who will treat the symptoms as well as labs and not only age. Most doctors see a 26 year old man and outright refuse TRT with no further discussion. You can always seek private care for your TRT in anti-aging and sports medicine.

Even if these doctors approved TRT, they probably wouldn’t optimize your levels, take this as a blessing in disguise.

I expect total testosterone to be higher, at least above midrange.

A TSH >2.5 is indicating a thyroid problem, we investigate by checking actual thyroid hormones, Free T3 is the master hormone, it increases metabolism, body temperatures and even affects neurotransmitters in the brain. There are more T3 receptors in the brain than the entire body.

There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 have an occult autoimmune thyroid disease. It is known 95% of normal individuals have TSH levels below 2.5 mU/liter.

https://www.ncbi.nlm.nih.gov/pubmed/16148345

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480274/

Hey system, how can you tell estrogen is being produced in the testes.

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Good point lol

You can’t, the telltale sign is anastrozole no matter the dosage doesn’t lower estrogen at all, you can throw 10mg of anastrozole at the estrogen problems and see no reduction in estrogen.

So you are forced to retreat testosterone in order to satisfy estrogen, hardly optimal. On TRT you don’t have these problems, you can have your cake and eat it to.

HCG for you = tons of Estrogen. forget it.

Prolactin 19.4 High ng/mL 4.0 - 15.2
LDL Cholesterol Calc 75 mg/dL 0 - 99
Triglycerides 98 mg/dL 0 - 149
BF 21-23%
Vitamin D, 25-Hydroxy 27.8 Low ng/mL 30.0 - 100.0
Fasting Glucose 117 High mg/dL 65 - 99

-you are eating too much carbs/sugar!! replace then for good fats. youtube it.

  • decrease bodyfat.
    -take 10k UI D vitamin / day and after a month twice a week if you dont take enough sun.

lol! thats great news, means that your axis still working.

Update:

I went to see a urologist and he said that I might have a small varicocele on my left side. I touched the topic with him about low T and he was pretty dismissive due to my musculature and full beard. Mind you I told him I rarely have sex with my girl friend…

Now what he said next blew my mind. He stated that if I have a higher androgen receptor density, then my body uses up more of the testosterone in the blood and that is why I am at where I am (475). He said that there is a feedback loop and that is why my body doesn’t make more T. Which is weird because I have all the symptoms of Low T I just have the genetics to grow a beard and work out a lot…

What do you guys think? I really don’t have a choice if I was to move forward apart from HCG monotherapy… I could reduce my carbs/sugar intake and increase fats. That will keep my estrogen in check. My LH level is 6.2 which negates anything being wrong with the signal not being there so it is likely my testicles that aren’t functioning correctly. Now how can I make them do their job better? Supplement with boron etc or do you think that’s all a gimmick? I wish to opt for the natural route before I go down this road. I am not super against the whole TRT aspec but more so not sure if I have closed all doors yet to different options.

Any input is greatly appreciated! Thanks all

I’m not buying his line about receptor density. You should give it a try if it’s being offered, but start looking for a different doc. Did he offer anything to lower your SHBG?

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Your doctor was trained in medical school to treat the reference ranges and ignore the symptoms and that’s exactly what he’s doing. So until such time your testosterone drops below 300, he’s going to sing the same tune.

The majority of stick care doctors are robots, in range no action, out of range is when they spring into action, welcome to sick care.

It’s real simple, you want TRT you’re going have to pay out of pocket for it. You’re not gonna get thyroid treatment with TSH of 3.0 either, you’ll have to pay out of pocket for that as well.