Advice Regarding HCG Monotherapy (Unusual Case)

Hi there,

New guy here. I know that most of my issues will fall outside the scope of these forums, but I’m hoping for any advice you’re able to give me.

I’m 39, exercise daily, sleep well, and my diet has been dialed for years. Prior to the lockdowns, I was in the best shape of my life (5’11, 163lbs, ~10% body fat). I was starting a clinical rotation as a med tech and needed a TDAP booster. A few days later, I started falling apart. Severe joint pain and instability (particularly of the C & T spine), bilateral parasthesia of the hands, vertigo, trouble swallowing. Symptoms resembled Ehlers Danlos Syndrome (a congenital connective tissue disorder). Rheumatologist ruled out RA, lupus, etc. Diagnosed me with an underlying hypermobility spectrum disorder exacerbated by an adverse reaction to the vaccine. He wrote me a script for PT and NSAIDs and sent me on my way.

I slowly improved, though my exercise tolerance never fully recovered. I thought the worst was behind me until the initial symptoms returned about 6 weeks ago. I have some theories, but I’m not sure why I relapsed. I’m throwing the kitchen sink at the problem and seeing every specialist I can in hopes of finding some relief. So far, I’ve started cold laser therapy, neuro PT, and I’m considering prolotherapy to address the spinal instability.

Along the way, I started reading about peptide therapy and decided to seek out an anti-aging clinic to advise. There are EDS patients who have had luck with BPC 157 & Ipamorelin. I found a clinic, and the doctor ran some bloodwork. She’s putting me on Ipamorelin (hasn’t arrived yet), a course of BPC 157 to follow, but she’s also started me on HCG monotherapy. Here’s where I’m hoping you guys might have some insight.

After reviewing my blood work, she thought my test levels could be improved. Since I’m not currently able to lift, her thinking is that further muscle loss will exacerbate the joint instability. I’ve already lost about 10lbs, and she wants to stave off sarcopenia as much as possible. I told her that I’m not keen on taking test indefinitely, at least not yet. She prescribed a course of HCG monotherapy, 500iu 3x/week for at least 3 months. Here are my labs:

Total test: 582 (264 - 916 ng/dl)
Free: 11.7 (8.8 - 25.1 pg/ml)
DHEA: 311 (102.6 - 416.3 ug)
SHBG: 34.5 (16.5 - 55.9 nmol/l)
Estradiol: 21.2 (7.6 - 42.6 pg/ml)
IGF-1: 146 (90 - 278 ng/ml)
TSH: 2.830 (.45 - 4.5 uIU/ml)
T3, free: 2.7 (2.0 - 4.4 pg/ ml)
T4, free: 1.23 (.82 - 1.77 ng/dl)

She didn’t run LH, FSH, etc. Just CBC and lipids, all in range.

I didn’t do my usual due diligence before taking my first injection, as I’m desperately grasping at straws in hopes of getting my life back to some degree. I went searching for info after I started having intense anxiety, which is what brought me here. Having read some accounts of HCG-related anxiety and other concerns related to monotherapy, I’m hoping to get a reality check on the wisdom of this part of her treatment plan. Any advice would be greatly appreciated.

Thanks in advance for your help.

I’m surprised she went this route, since your TT and FT aren’t horrible and if concerned about muscle wasting something like Oxandrolone would make more sense (with clinical backing). I like the idea of the peptides, check IGF-1 after a month or so. BPC has been magic anytime I screw my back or shoulder up.

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So am I, HCG should not be used as a replacement for TRT. HCG mono isn’t nearly as effective as TRT in the majority of cases.

In your opinion, is there any utility in continuing the 3 months of HCG mono? Or is TRT a reasonable consideration given my labs? HRT of any kind had not been part of the initial game plan, but if my current symptoms could be improved in any way I’m obviously willing to consider it. That being said, it’s seems difficult to determine if any of them are actually related to my hormone levels. Before the initial episode, I had never felt better.

You’re in what’s considered the gray area, meaning your Free T is close to the bottom of the normal ranges, which is strange considering your SHBG isn’t even moderately elevated and your Total T is 600 ng/dL.

Hormones are complicated, receptor sensitivity (CAG repeat lengths) will dictate how much testosterone you need to function normally, so it’s difficult to say with absolute certainty that testosterone is your problem.

I have seen men on this forum with Total T at 159 and no symptoms who were just checking their levels out of curiosity.

So as you can see labs don’t can’t always be relied upon for accurate diagnosis in every case.

I don’t know what she hopes to achieve with this treatment. The day after I take HCG my TT is 35. That’s not a typo. I’m not sure how much I would need to use in order to mimic normal testosterone levels but 250 eod barely moves the needle for me. Maybe you get a much better response because you’re not on a bunch of other stuff that’s highly suppressive like I am, but you have perfectly normal test levels. If you jump from 582 to 850 you will notice zero difference in almost all aspects of life, including muscle retention. This feels a lot like a doctor who has a solution and she’s searching for a problem into which she can plug it.

She went hCG monotherapy as the risk with this therapy in terms of long term shut-down of your HPTA is much less than starting you straight off with typical anti-aging dose of TRT. She wants to see what your TT response is to the hCG (too bad you don’t have baseline LH/FSH). If you get a response on your TT (say up to 800 ng/dl) then how will that affect your quality of life? It takes time to manifest. Clearly you aren’t primary hypo and not secondary either but if your testicles are functional (Hint: they are), then good chance you will get a decent bump with the hCG therapy she prescribed.

If you aren’t satisfied with the improvement you can always go to TRT but it is for life and after 3.5 years I can tell you it isn’t a silver bullet (in terms of what you are looking for). I started with TT/fT levels lower than you and I’m in a similar boat to you in terms of issues. Anecdote: I did everything else I could before starting TRT. TRT is for life and if you want to go off (for whatever reason) there’s no guarantee you will recover HPTA especially the older you get (and with some of these AA-clinic protocols). Think hard and choose wisely.

Good first trial in my opinion. Give the higher TT levels a few months to manifest (if you get the bump). To @iron_yuppie 's point, you may not feel any better. I didn’t with hCG mono. Now my symptoms aren’t any better with TRT but I am jacked and shredded and joints hurt worse since I am lifting heavier weights :-).

@readalot makes sense, particularly if the doctor is looking for a short term boost (I don’t know if that is a correct objective) to help fix an acute problem…without the suppression effects of T.