T Nation

Beginning HCG Mono


So I just started HCG Mono today. It is supposed to help boost both my testosterone as well as cortisol levels. My protocol is 500 IU every 3 days (E3D) but I am going to start out with just 400 IU E3D. My dr will add in an AI if/when E2 gets >45. Is this protocol reasonable?

Labs just 1 week before:

TT: 450 (250-110 ng/dL)
FT: 82.0 (46-224 pg/mL)
SHBG: 21 (10-50 nmol/L)
Cortisol: 11 (3-20 ug/dL)
LH: 2.8 (1.5-9.3 mIU/mL)
FSH: 1.0 (1.6-8.0 mIU/mL)

(Cortisol is slightly low due to low LH/FSH, clomid had increased it when I was on it)


Waiting for E2>45 is insane. If you get high T-->E2 inside the testes, anastrozole will not control that source of E2. Good protocol if its a good endpoint for you. If T levels then not good enough, inject T + 250iu hCG SC EOD


I am already starting to get symptoms of high E2 I think and I have only taken 3 injections. (1 week worth) But how can this happen so quickly? It makes me question if HCG mono is a good treatment for me even if an AI is added. I will be testing soon since I am responding quickly based on symptoms.

The anxiety is lower but now I am getting symptoms of depression which is worse than the anxiety for me. I feel emotionally numbed out and have low motivation. It feels like I am on an SSRI but I am not.
Perhaps E2 affects serotonin levels in some way?

Also erections aren't better--still soft.


If hCG dose is too high, for an individual, intratesticular testosterone [ITT] levels are very high and T-->E2 rates in the testes can be very high and anastrozole CANNOT reduce that T-->E2 rate. Cut dose in half and see what happens. Try injecting EOD so the hCG peaks are less as well.

hmm .. I did say: "If you get high T-->E2 inside the testes, anastrozole will not control that source of E2."


But what if I really, really want it to work?


it's kind of ridiculous that your doctor made a statement that he's going to wait on the AI until E2>45...in itself this is ridiculous, then considering you haven't listed a pre-HCG E2 level, so I'm assuming he didn't bother to check that. For all he knows you're starting off at 45! That's an example of a doctor maybe being close to being on the right path, but not quite there get so fills in the gaps with bullshit.

for what it's worth to you- pre-TRT I was at E2 of 22, but with T of 401. A month of 100mg/wk of t Cyp later and my T had more than doubled to 855, and so did my E2- to 44. And that increase from 22 to 44 left me panicking for a few weeks with puffy and sore nipples which then had to be taken care of by a couple weeks of Tamoxifen. it was a bit of a pain in the ass.

I think you should push for the AI now. maybe .5mg arimidex/wk...if your next test shows your E2 lower than 22, then make adjustments.


Oh oops--- my pre HCG E2 was 26 pg/mL in that test, but it seemed to have fluctuated to as high as 30 before. I was getting bad symptoms of depression on random days so I decided to have blood drawn after my 4th injection on the protocol of HCG 500 IU E3D.

Total T: 680 ng/dL (348-1197 ng/dL)
Free T: 197 (52-280 pg/mL)
SHBG: 20.1 nmol/L (16.5-55.9)
E2: 44 pg/mL
Vit D: 38 ng/mL (30-100)
Ferritin: 29 ng/mL (30-400)

So my dr changed my protocol to 250 IU EOD and has also provided me with pills of 1 mg Anastrazole and said to take maybe 0.5 mg 2x a week. He said I could adjust the dosing of both the HCG/AI based on symptoms but that is the new starting point. He told me I am an aromatizer. Hopefully this protocol will work out. I have been taking Vit D 2000 IU every day but somehow my levels dropped from 44 so I will be taking 5000 IU every day. The only problem with this dose of Vit D is that it depletes magnesium. I will also be taking Iron supplements. My RBC and hemoglobin are normal so this is just a slight iron deficiency, no anemia.


Most people are magnesium deficient. The issue may be that large dose vit-D3 "discloses" cases of magnesium deficiency.

I have always consumed milk and despite that, my leg and foot muscles were always crampy. I could tighten those muscle groups and induce cramping at any time. I now take a magnesium supplement at night and that crampy tendency is gone. I have also works with others IRL where magnesium supplements resolved leg cramping. I do sometimes ask guys here about leg cramps. I also suggest multi-vits that contain trace elements. There are many critical chemical processes in your body that are performed by enzymes and most [all?] enzymes have a metal atom at heart that is the catalyst. There simply is often not enough critical elements and other compounds in food/diets and problems can easily arise. Multiple deficiencies to some degree are the norm, our "natural" state is never optimal. Some things stress these deficiencies. Some extremes of diet can create absorption deficiencies.

A good example of such things is selenium deficiency that leads to thyroid inflammation that can lead to thyroid auto-immune disease.


Well it doesn't seem like HCG Mono is that great for me but I may not have given enough time. WIth the Anastrazole 0.25 mg EOD (~4x/week), my estradiol went too low and the HCG is depleting my previously low cholesterol even more. The low cholesterol is genetic ApoB deficiency and I've been doing things to increase it but none of it is really working like eating eggs, etc. It seems like its getting down to really really low levels and this is pretty bad.

Cholesterol, Total: 100 mg/dL (100-189)
LDL: 47

Total T: 621 ng/dL (348-1197)
Free T (Direct Assay) : >50 pg/mL (9.3-26.5) This assay is different than the previous test, which was done by dialysis
Estradiol,LCMS : 16 pg/mL (8.0-35)

Cortisol: 13.3 (3-20 ug/dL) Seems like HCG isn't increasing this as well as Clomid did
Prolactin: 13.7 (4.0-15.2 ng/mL) Slightly on the higher end, is it a big deal?

I do feel somewhat better but not as much as I hoped, and at one point on Clomid before it destroyed me I had felt better than this. Perhaps its the Cortisol? The fatigue has improved but current symptoms are mild anxiety, low motivation, occasional morning wood, ED sometimes, testicles looking pre-pubescent often (but not always), orgasm not as pleasurable. Thyroid is optimal--Had it re-checked 1 month back and TSH was around 1 while free T3 was in the upper quarter of the range at like 380. No antibodies found.

I am considering asking for a switch to Nolvadex since it will probably improve the cortisol levels like Clomid did. What is the dosing though and since Nolva is an anti-estrogen an AI would be unnecessary?


So I am thinking of switching to a SERM. Either Toremefine or Nolvadex hopefully. Has anyone actually tried Nolva monotherapy or Toremefine monotherapy with good results?

HCG just doesn't seem to be working well for me--I feel low the day after an injection even at 250 IU SC every other day. My cortisol is also not being boosted as much as it went up with a SERM. In addition, my cholesterol drops too much on HCG. Its been tough to get up the LDL as the low cholesterol is all genetic and my liver doesn't seem to manufacture as much of it. So my body is essentially a natural statin.


So now after switching to HCG 250 IU EOD my cortisol levels are dropping? Wtf? I think I really do need to get on a SERM.

Testosterone, Total: 693 ng/dL (348-1197 ng/dL)
Testosterone, Free: 166 pg/mL (52-280 pg/mL) 2.4% (1.5-3/2%)
SHBG: 18.8 nmol/L (16.5-55.9)

Estradiol, LCMS: 25 pg/mL (8.0-35 pg/mL)
Prolactin: 14.7 ng/mL (4.0-15.2 ng/mL)
DHT: 39 (30-85 ng/dL)
Cortisol, AM: 8.5 ug/dL (8.0-19 ug/dL)

Vitamin D: 43 (30-100 ng/mL)


was that bloodwork done in the AM ?
That is really low in the cortisol dept..
I don't have any advice.. and don't understand how HCG could affect it

BTW - your test numbers look good IMO

Keep us posted


" Thyroid is optimal--Had it re-checked 1 month back and TSH was around 1 while free T3 was in the upper quarter of the range at like 380. No antibodies found. "

Then your waking and mid-afternoon oral body temperatures should be >=97.7 and 98.6

If fT3 is midrange or higher, and body temps are low, need to look at rT3