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41, Testosterone Count 284. Test Cyp w/ HCG or No HCG? with updated lab results

Doctor put me on 1cc of Testosterone Cyp and no HCG, I thought the dose was to high so decided to only use 2x50mg (Tuesday night and Saturday morning) only took one injection so far and after reading the internet I am nervous that I need to be on HCG as well. Like I stated I am 41, I already have two kids and got a vasectomy a few years back so not concerned about being sterile. Should I continue injecting or make another appointment to ask about HCG. Thanks.

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Hcg would be to keep your balls from shrinking and to stay fertile. If the person doesn’t care about those 2 then no need to use HCG.

You need to be concerned about not having an AI (Anastrozole) to keep your estrogen levels in check. Do you have blood work from before trt? At least total test and estradiol (E2).

By injecting test, your E2 will more than likely go up. Not only will you not feel the benefits of the testosterone but there are some bad side effects of too high or too low E2 and you need to manage it at a certain level.

Depending where you live you can get your own private blood work done at privatemdlabs.com

Please post all of your labs with ranges.
LH/FSH from before TRT, cannot test later

You can inject T with #29 1/2" 0.5ml insulin syringes. Inject SC/SQ upper legs where you can see what you are doing and avoiding veins that you can see.

250iu hCG SC EOD is all that you need. Many report an improvement in mood with hCG. Without hCG, we often have guys report a 24x7 dull ache in their testes. Sometimes we see wive/GF concerned with testes shrinking and maintaining size of testes is important for some guys as part of sexual self-image. The testes produce other hormones, significant amounts of pregnenolone that is used to produce downstream hormones in the adrenals [progesterone for progesterone–>cortisol, DHEA and others]. Without hCG the testes get smaller and the scrotum pulls up tight, however a few [rare?] report none of this without hCG. hCG acts just like LH and hCG is a natural human hormone, you were swimming in hCG inside the womb for a few months.

Doctors typically do TRT wrong. When you know what you want, the Finding a TRT Doc sticky is useful.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

I’ve been on TRT for almost 4 years now. I’ve never been on HCG, and my balls are the same size they’ve been for as far back as I can remember.

I’m 48, and I’m not having any more children.

Thanks for all the comments, I don’t have all my levels but will ask the doctor. I am now more concerned with E2 than hcg, will a new blood test be sufficient for E2 levels and treatment or do I need the numbers before and after starting treatment using Test Cyp.

I was 41 when I started and my first two lab results for TT was 237 and 136. I haven’t used hCG at all, but I’m considering it since I have been reading it helps with memory.

If you are unconcerned about kids and the size of your balls, you don’t really need it otherwise. Mine have become a little more “squishy”, but I wouldn’t say smaller. I’ve been on for 1.5 years roughly.

Sorry KSman just received the fax with all the information you asked minus the E2 which I didnt see on the report. I started Test Cyp 100mg a week split into 2 doses every 3.5 days (Saturday and tuesday). Had 4 injections and not feeling anything at this point, had morning wood yesterday for the first time in ages but nothing today. truley appreciate any help reading the results below.


TT - 284 (198-679)
FT - 8.2 (6.8-21.5)
E2 - Didnt see this on the labs
LH - 3.9 (1.24 - 8.62)
FSH - 5.20 (1.27 - 19.26)
CBC - RBC 4.57 (3.68 - 5.06), WBC 6.7 (3.6 - 10.9)
hematocrit - 14 (12-17)
AST - 18 (13-39)
ALT - 25 (7-52)
SHBG - 29.6 (13.3 - 89.5)
Vit D - 54.3 (>30)
Prolactin - 4.13

Thyroid Numbers:
Thyroid Numbers
Free T3 - 3.0 (2.0 - 4.4)
T3 Total - 80 (70 - 180)
Free T4 - .98 (.60 - 1.77)
T4 Total - 6.80 (4.50 - 12.50)
T Uptake - 45 (32.0 - 48.4)
TSH 3rd IS - 1.474 (.45 - 5.33)
Free thyroxine Index - 7.65 (3.60 - 15)

I have all the thyroid levels as well if that helps.

Anyone able to help out with my labs.

Glossamer: Your experience is rare and you should not be distracting OP.

You seem to have mixed primary and secondary hypogonadism. With low FT and lower SHBG, elevated E2 is most likely not a cause or a factor. Prolactin is not a cause. Blows to the head can damage the pituitary, which you should know from the stickies.

I also pointed out the importance of thyroid already, so please post thyroid labs.

Try to keep all of your case in this thread and not split your case over multiple thread.

Do not test E2 now, see if you can test these at 4 weeks:
That will tell you if adjustments are needed.

E2=22pg/ml is a suggested target that for most is optimal for fat loss, fat patterns, energy, mood, libido and socialization. You will need to get a doc on board with that. There is more that you must know in the stickies re anastrozole over-responders - please to not skip the stickies. And with that, you will see that it is expected that you will provide a lot more information.

Sorry KSman for starting another thread, I added my thyroid numbers in this post. I tried to delete the other thread I created but didnt see delete function.

Thyroid Numbers
Free T3 - 3.0 (2.0 - 4.4)
T3 Total - 80 (70 - 180)
Free T4 - .98 (.60 - 1.77)
T4 Total - 6.80 (4.50 - 12.50)
T Uptake - 45 (32.0 - 48.4)
TSH 3rd IS - 1.474 (.45 - 5.33)
Free thyroxine Index - 7.65 (3.60 - 15)

fT3 is near mid range and should support good body temperatures. I asked in my first post here that you check oral body temperatures.
T3= is below midrange
fT4=.98 is below midrange
T4=6.8 is below midrange
TSH=1.47 should be closer to 1.0
With fT3 and fT4 labs, uptake and index labs are obsolete - avoid

You might be a bit iodine deficient. Are you using iodized salt - history please.

Body temperatures are very important, please report. Labs are often not enough and your set of labs was quite thorough. The only missing data is how your body reacts with those numbers [temperatures] and that will indicate if rT3 [not tested] could be a factor. rT3 is typically not tested unless something else suggests an issue.

Yeah no rT3 value just looked again.

Possibly could be iodine deficient, I typically use sea salt. Recently started using regular table salt with iodine after reading your other post.

Dont have temps but will start to measure.

Have you ever seen a total testosterone range like the one I was tested against 284 (198-679). Seem very different from most reports I see.

Sorry to be a pain in the ass but I just want to make sure that I am taking Test Cyp for the right reasons.

Lastly you mention Blows to the head can damage the pituitary, I have not experienced any head injuries in my life.

Please have selenium in your vitamins for this. Selenium needed for enzymes that clean up free radicals normally produced during T4 production. If that fails, tissue damage and inflammation might be misinterpreted by the immune system and you have a thyroid auto-immune disease. Introduction of iodine is a risk window for this.


I’m trying to help the OP, just like all of you are. Just because I’m not as knowledgeable as you, does that mean my experience is not important?

KSman, instead of harassing me for trying to show the OP that his balls may not shrink to raisins, why don’t you just help him your way, and let him decide if he wants to listen to what my experience has been?

You seriously felt like you needed to reprimand me here and via email, for this?


I try to teach the basics and when a new guys sees a post like that one that is not properly qualified, it may create confusion. It seems quite unusual that HPTA does not lead to testicular shrinkage. You could have addressed this differently by suggested that the issue does not always occur and that one could wait and see then use hCG if/when testes shrink. I am trying to be better at deeply qualifying my statements, but it ends up taking a lot more time+text to get there. Maybe you can step in when needed. - thanks

Is my experience really that rare? In all the studying you’ve done, do the overwhelming majority of TRT patients who do not use hcg, have extreme testicular shrinkage?

I’m not as studied as you are on this subject, but from what I’ve read, plenty of older men have done fine on long term TRT without hcg. And another thing which I feel is understated, is the lack/absence of studies that show the long term “side” effects of male hcg use.

And you do not see studies of long term [side]effects of TRT induced LH/FSH–>zero.

For most, hCG is simply a uncomplicated replacement for LH activation of LH receptor cascade.

But the short term effects of LH/FSH deprivaton are well understood:

  • probable testicular shrinkage
  • probable scrotum pulling up tight with visual similarity of a prepubescent boy
  • possible 24x7 ache
  • risk of reduced sperm count or infertility
  • above can affect one’s sexual self-image or how one is regarded by wife/GF
  • loss of other testicular hormones [tanked my pregnenolone for an example]
  • hCG resolves all of the above, however a very few are hCG intolerant.

Myself and other have reported that it was wives who raised the alert about testes being smaller and pulled up. So the concern can easily involve more than one person. Ever watch port with a stud with a BB physique and tiny balls, dude is on gear and not using hCG.

From my ~ 10 years here [and my own experience], these problems are very common and thus expected. From your viewpoint, your experience may seem universal.

Also needing to be discussed is how many report hCG creates a large mood improvement. Had one guy I supported via his wife in PM’s [RIP] who was hugely euphoric on hCG.

I can’t be the only person who’s on TRT, and doesn’t have raisins for balls. I certainly don’t think my situation happens to everyone, but I don’t think it’s as rare as you make it sound.

One thing I considered, seeing how this is a steroid forum, is that many men on TRT, cruise on a TRT dose, while also taking larger/bodybuilding doses of test and other steroids. Is is possible that once one’s test levels are above the “normal” range, that’s when testicle shrinkage is more common without hcg? Almost a correlation between higher test levels and smaller testicles?

You’re the expert here. But I just want to throw out the option that many older men, not concerned with fertility, do not take hcg, and do not have raisins for balls.

I’m speaking specifically about TRT doses, not doses that raise test levels to bodybuilding levels.

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