T Nation

Adding HCG to my TRT


#1

Hi, I’m looking to add HCG to my TRT regimen for fertility reasons and looking for suggestions on dosages for everything as well as any feedback as to what to expect. I just had a sperm count done and there was none found. The fertility doc ran the following labs.
Total Testosterone: 1280 (blood test was done within 4 hours of my morning test cyp shot.) (280-800)
E2: 35 (non-sensitive test) (7.63-42.6)
Prolactin: 2.84 (4.04-15.2)
LH: 0.27 (1.7-8.6)
FSH: 0.16 (1.5-12.4)
TSH ultrasensitive: 1.79 (0.27-4.2)

I was diagnosed in September, 2015 of being hypogonadism and have been taking 0.25ml of test cyp every 3.5 days. I’m currently taking 0.25mg of anastrozole every 2.5 days. Prior to starting on trt my labs showed:
Total testo: 249
LH: 3.3 (2-12)
FSH 5.2 (1-12)

From my reading I understand taking HCG is needed to compensate for the low LH and possibly HMG for the low FSH. So my questions:

  1. What dosage of HCG should I be looking to take?

  2. How much should I lower my testo dosage since my peak is already a little over 1280? My trough testo was 1080 about 6 weeks ago. I was thinking of dropping it to 0.4ml every 3.5 days.

  3. How much should I up my anastrazole dosage after I start the HCG. I was thinking of going to 0.25mg every 2.0 days to start off with. I was on that dosage a couple months ago but it drove my e2 down too low.

  4. Do you think the HCG is enough to get my sperm count to where it needs to be for having a child or should I be adding something for the FSH?

  5. I’m still not sure what’s going on with my low prolactin. This is the third test and it keeps dropping. My general doc told me not to worry about it but I’ve read the study about how having prolactin under 5 can cause ED issues. If anyone has thoughts as to why its dropping I’d love to hear them, as well as suggestions on how to raise it a little.


#2

Stating your T dose I’m ml’s is useless. Some T cyp comes 100mg in 10ml and some come 200mg in 10 ml. So we need to know dose in mg.

Obviously not taking enough AI to control E2. So you’ll either have to reduce T, increase AI or a combo of both to get E2 closer to 22.


#3

The test cyp is 200 mg/ml.

As for my e2 I know to get it in the 20’s but since it was done with the non-sensitive test shouldn’t I take off a few points from the 35? Regardless of my current AI dosage, won’t I have to up the anastazole dosage anyway since the HCG will raise my testosterone a little, which in turn will raise my e2 a little? Hence the reason to up my AI anyway?


#4

First, I hope your entire football team dies in a fire.

Second, you are taking a lot of T cyp. Most guys on TRT are right around 100mg/week in two injections per week. They also take 1mg of adex for every 100mg of T cyp.


#5

Is my math off? If I’m taking 0.5 per injection every 3.5 days. Isn’t that 1ml per week, or 100mg per week?

1 mg of adex a week is too much for me. I’ve tried different dosages in the past few months and been too low twice and too high a couple times.


#6

You are taking 200mg T per week, 100mg twice week.
You are taking ,0.7mg anastrozole per week.
We expect that most guys will need 1mg anastrozole for every 100mg T per week.

To get near target of E2=22pg/ml your new dose of anastrozole should be 0.7mg x 35/22 = 1.14mg/week or .507mg twice a week.

Take 1/2mg anastrozole at time of your injection.

Why were you doing anastrozole very 2.5 days? Was that a typo for 3.5?

There is no reason to test LH/FSH again!

TSH should be near 1.0, 1.79 is too high. Ignore the lab range. Doctor thinks that this is fine, I do not.

I posted this to your other thread a month ago:

Thyroid seems to be the only player not on the field.

See these links found here: Advice about HPTA Restart

  • advice for new guys
  • protocol for injections
  • things that damage your hormones
  • thyroid basics explained <-- check you oral body temperatures as suggested

Have you always used iodized salt?
Feel cold easily?
Outer eyebrows sparse?

If body temperatures are low, do these labs:
TSH
fT3
fT4 [please not T3, T4]


#7

I tried 0.5 mg of anastrozole every 3.5 days and my e2 was too low. I then tried 0.25 mg every 3.5 days and it went to the 50’s. Then I tried 0.25 every 2.0 days and my e2 dropped too low. I get aches in my hands when its too low. Then I went to taking 0.25 every 2.5 days and the aches in my hands went away and my e2 is the 35 I just got back.

I make sure to use iodized salt as a result of reading this forum. I rarely feel cold and tolerate cold weather better than most. For me its the opposite. I tend to be warm when others are in jackets and I’m even wearing shorts and a tshirt. My eyebrows are thick.

The main reason I’m posting is to figure out how much I need to adjust my test cyp dosage and anastrozole dosage once I start the HCG. I’m assuming that my testo will go up as a result of the HCG, which in turn will cause my e2 to go up since my body has done than since going on TRT. Is it possible that since I’m primary hypo that my testo won’t go up at all? Should I just leave my testo and AI dosage the same for the first weeks after starting HCG and see what my next lab results show?


#8

For most, hCG creates a small increase in T. In my case is was 17%.

With those anastrozole dosing changes, was T dosing unchanged?

Based on your current TT, andyour T dose, 1mg anastrozole per week would make sense.

You will have to experiment with dosing. A liquid product allow for flexible dosing, 1mg per 1ml vodka.

So it will not hurt to post your oral body temperatures and really see what is going on.

I do not think that there is anything wrong with TT=1280. It would have been good to see what your FT was.

Edit: for corrected T dosing info


#9

Okay, now I see where I made my error. I’m taking 0.25ml of testo cyp every 3.5 days, not 0.5ml. Sorry about that. I’ll fix it in my original post.

This last set of labs didn’t include the free test. My free testo score on my previous labs on 4/15/16 was 72.79 pg/ml (1.00-28.28). My testo score on that test was 1080 for my trough.

Is it a bad idea to go with 0.25mg of anastrazole every 2.5 days. I know the half life is around 50 hours but that’s on the average and can vary from person to person. If its better to make it into a liquid form with the vodka to allow me to take it every 2 days then I’ll do that.

I’ll take body temps and post when I have them.


#10

Thanks for the correction!

Some do T+AI or T+AI+hCG EOD to get very steady levels. Then anastrozole, a competitive drug is matched to steady T levels.

But injecting twice a week can work well. T levels change a bit. Taking anastrozole at time of injections has serum levels of T and anastrozole peaking and troughing roughly together and AI works well. Throwing AI E2.5D will create some odd waves of effectiveness and E2 levels.


#11

Whew, I thought we were dealing with some strange math they teach at auburn!

I agree with KSman. Injecting hcg according to the protocol will increase T a small amount. The only way you are going to know what adjustments to make in adex is to add the hcg for a few weeks then have lab work done half way between T injections.

I inject 250iu of hcg E3D instead of EOD. I’m 54 and don’t care about fertility. I want enough hcg to keep the boys happy but don’t want to increase E2 too much. I’ve found after 4 months of this stuff, E2 levels are the most important aspect of feeling good.


#12

Well, my visit with the new doctor (urologist) didn’t go well. Just before he came in to talk to me I could hear the nurse giving him the run-down of why I was there and she told him I was taking 0.25 ml shots of testo each week and didn’t know why I wasn’t taking just one shot every two weeks, so right off I knew it was going to a bumpy meeting.

Basically, he said he didn’t like my current trt regimen and said that a testo score of about 240 (that’s what I tested at before starting trt) was in the normal range or just under it and that he wouldn’t put a man on anything to raise testo. I told him that it makes no sense to live that way and I wouldn’t go back to it after being on testo and feeling like I’m in my 20’s again (btw, I’m 43).

He said if I wanted to add HCG to try to regain my sperm count for fertility reasons that he would want to take me off the testo and just give me the HCG. That part didn’t surprise me since I’ve read that some do it that way. After talking for awhile he admitted that I may be more up on the current research than what he was and he admitted that he’s an old school doctor (I think he’s about 70 years old). He did finally say that he would agree to put me on HCG but that it would be done at his office and I’d have to have blood tests every 6 weeks, and that the shot would be 10,000 units. As far as I know that’s a lot to take at once and not something I want to get into because I’ll crash whatever testosterone before the next shot. Isn’t the half-life of just 2 or 3 days for HCG? And wouldn’t I be putting myself at risk of desensitizing my LH receptors with such a large dosage?

He also saw that I was on zinc and said that taking zinc does nothing for raising zinc levels when taken in pill form and that there was no evidence to show that it helps with testosterone production. My primary doc has me taking 50-100 mg per day of zinc to help prevent my body from turning testo into estradiol.

He went on to say that he didn’t feel comfortable with a testo score at 1000 like I’ve got and started talking about steroid users and the dangers, which I replied by pointing out that comparing guys with ridiculously high testo scores in the thousands isn’t the same as having a 1000 test score. Ultimately he just said he couldn’t help me and suggested that I find a different doctor.


#13

The guy is a moron and he is right, you need a new doctor. Test levels of 240 is no way to live.


#14

I’m sure you’ve got a million messages like this but I’m starting a very similar protocol to the one explicated here and would really appreciate some help as doctors don’t out much attention, seemingly.

I was in hcg mono+AI and raised total T from 520 to 1630 but free T remained utterly low. Hence pointless lots of T and higher E2. Whilst on this protocol LH and FSH were around 0.5

Now I’m starting twice o’er week 70 mg cyp and AI only if E2 does raise a lot as AI screwed up my erection.

Please advise as to T+HCG’s worthwhile and mat I use HCG longer than 3 weeks as I found for me it somehow doesn’t work well enough after w3.
If I may not use it for too long , is there logic in using it at all - raising LH mimic for few weeks thence shutting down again…

Thanking you sincerely
Kris


#15

If you are concerned with fertility or maintaining testicle size than you may still want HCG . HCG bypasses pituitary. It mimics LH and goes directly to the lh receptors. So even though lh is 0 HCG is acting like lh.


#16

Thank you for the reply Charlie!

My concern is that hcg can be used temporary not to burnout the receptors , or am I mistaking I.e. if I use small doses 300-500 iu twice per week , could I use it for a longer period e.g 2-4 years?

Lastly, isn’t FSH responsible indeed for the fertility? If hcg just mimics lh isn’t FSH and fertility forgotten?

⁣pls excuse me I didn’t give much info:
29 y o
On hcg mono - 1630 total T with 78 E2 and below 0.5 LH and FSH
Now on nothing (clomid didn’t work well on me) I’m at 520 total T 20 E2, FSH and LH circa 3.5 , various low symptoms

Is freezing semen prior to TRT viable option?


#18

Absolutely freeze some sperm, good idea. I’ve heard LH stimulates T and FSH stimulates sperm, beyond that I know nothing else. I think like TRT, HCG doses are unique to the individual.


#19

When on trt your lh test would come up very low , so even if progesterone makes lh trt would have decreased it, hence usage of hcg but what about FSH… Most people are against HMG…

I hope clomid worms for you! I used it twice x 2-3 weeks and have to say it really lowered quality of life…

⁣Sent from Blue ​