T Nation

Changing from TRT to HCG, Feeling Awful

Hi all, First time poster.

I’ve been on trt due to low levels for about the past two years. Now that my wife and I want to conceive another child, my doc has put me on hcg and took me off trt.

I started the switch nearly 2 months ago and during the last week or so, I’ve felt pretty rough. Been more depressed than usual, irritable, tired, and have anxiety attacks.

My question is could these symptoms be a result of coming off trt and going onto hcg?

I was taking 1ml trt injections every other week and now on 1 ml of hcg 2x weekly (not taking any trt now).

Has anyone had a similar experience? Or could my issues be from something else.

Thanks

I can’t imagine you felt good on an every other week protocol, only inexperienced doctors hand out these horrible protocols. You won’t find a single member here who injects T every other week. Most inject two or more times per week.

There’s no need to quit TRT to conceive, HCG and FSH injections is a game changer for sperm production. FSH suppression caused by TRT is why you can’t conceive, so you inject FSH together with HCG.

HCG is measured in IU, not ml. Time to find a real TRT specialist.

That’s interesting that the every other week dosage isn’t common. I had no idea.

I may not have felt as great as others getting more frequent doses, but I felt way better then than now.

The prescribing doc is a reproductive endocrinologist so I assumed his recommendations were fine.

I am going to talk to him further about it.

So do you think the switch to hcg only could be triggering these symptoms? Perhaps I’m not giving the shots correctly. I haven’t been doing them at 90 degree angle (didn’t realize that was right until I found this forum). Maybe I’m not getting enough hcg because I was doing the shots improperly?

My wife is a nurse and had been giving the shots. However she is away for a couple of months so I’ve had to do it myself.

Hi gilestis welcome to the forum.
HCG and FSH injections with TRT is not guaranteed. One guy on ExelMail(miss-sp, on purpose) reported doing that and got his wife pregnant. Now all of a sudden it just works for everyone. I don’t think so.

The symptoms you are reporting can come from either the T crash or HCG. Some guys don’t respond well to HCG. Respond meaning they feel like shit. HCG simulates LH which is the hormone that tells your balls to make T. FSH is the hormone that tells your balls to make sperm.

I would have tried to do a natural T restart like the guys over in pharma do when they blast.
Blasting shuts your natural production down just like TRT. The PCT gets their pituitary gland and testis working again.
Novadex (tamoxfen) is the drug of choice. It is usually taken at different amounts per week. 40/40/20/20/20 get a blood test. for TT/FT and E2

I hope that helps. Did your doctor not tell you when you started TRT there’s a 95% chance it would make you sterile?

The testosterone cypionate packaging inserts say to inject 200mg every 2 weeks, so your reproductive endocrinologist follows it precisely without any knowledge, the half life of T-cyp is 7 days in the real world, on paper its 12 days, so by day 14 your levels are way below the therapeutic ranges, this reflects your less than optimal TRT results.

Endocrinologist and urologists are not the type of doctor you want to see for TRT, there is no doctor in sick care I would ever seek treatment for TRT or thyroid issues because they don’t optimize you.

They have these cookie cutter protocols for everyone to make their experience more painless as they shuffle through 20 patients in an 8 hour shift. You need to find a doctors with who will optimize you, I seriously doubt you’ve ever been optimised on TRT or felt your absolute best.

These doctors can be found private in anti-aging and sports medicine and typically don’t take insurance, they wouldn’t be able to do their job if they did.

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Well I am switching to clomid as of today.

Took my last dose of hcg on Saturday and have felt up and down since.

My insurance will not cover any more hcg so I am hoping clomid will be good.

I just got my lab results back:
Testosterone (Total,LC/MS/MS): 441
FSH: 0.3
Estradiol: 37.0

Doc said the labs look great but was hoping you guys could share your thoughts.

Do these numbers look indicative of causing anxiety/depression?

Well your FSH is still shutdown because of the HCG. A TT of 441 with just HCG is pretty impressive and here’s hoping clomid works even better. There is a very good chance here your balls are working and your issue is with the pituitary gland and that is very good news since you two want to make babies.

Thanks for the encouraging reply. I’m hoping all this will be worth it. Been on clomid about 5-6 days and feel pretty spaced out. Hopefully my T comes up soon and eases these side effects.

Clomid has many side effects most men can’t tolerate even though levels are perfect, clomid blocks estrogen in the brain to increase LH and therefore testosterone.

The goal should be to get the wife pregnant so you can hop back on TRT, not every other week though. Spend some time researching and you’ll see how uncommon every 2 weeks protocol really are for those who respond well to TRT, only inexperienced doctors prescribe these dumb protocols for a hormone with a half life of 7 days.

The study below shows what happens to men who are injected with 200mg every 2 weeks, after 6 days levels are below the therapeutic ranges which is understandable considering the half life of T-cypionate is 7 days, 12 days on paper.

Two or more injections per week is ideal, sorry your doctor is clueless. I inject 24mg every 2 days and am working with a private doctor who knows how to play this TRT game.

Skip to figure 1 graph B
Hormone profiles after intramuscular injection of 200mg testosterone enanthate every 2 weeks in patients with hypogonadism

You are welcome man. Don’t let these Debbie downer T junkies get to you. Clomid can have some negative side effects but if you start low and work your dose up they will be minimized.
It is no different than starting T large dose right out of the gate and you will suffer greatly.

If clomid is really giving you problems look into enclomiphene.*

Besides you need to give the meds time to do their magic anyway. So keep buying the wine and candles an spoon your ass off. You might have to look that term up its pretty old, haha. When you are old and gray these are the stories of your life you two will talk about and remember.

ref: my good friend Cat at PeakT *For those who are unaware, enclomiphene is the non-estrogenic component of Clomid/clomiphene. There’s been a thus-far unsuccessful attempt to have this drug approved for hypogonadism under the name Androxal. Anyone taking or considering taking Clomid should think about enclomiphene as a potentially better option. Some of the unwanted side effects of Clomid are attributable to the zuclomiphene component. In addition, enclomiphene has a short half-life, around ten hours, meaning it’s relatively easy to change protocols or stop taking it. Zuclomiphene has a very long half-life, maybe as much as a month, and therefore takes a long time to get out of your system.

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Thanks for all of the replies. You guys seem very knowledgeable and I appreciate you sharing your input.

I’m now at the 2 week mark for clomid and the depression is terrible. Also is the brain fog and slowed cognition.

I’m talking to my doc about adding a medicine to lower estradiol levels.

It doesn’t sound like you are doing too well on the clomid. What is your dose?
Also you know you can buy HCG from the internet no script required. Just saying. Might want to do some research in that.
Also did you ask the doc about enclomiphene? That might also be worth a try.
When is your next blood test?
Those to can be bought off the internet no scrip and you can buy just the tests you want. It is amazing how much a blood test will give you piece of mind. Right now TT/FT is on sale for 30 bucks.

I didn’t see anyone else really address this, but… when you said HCG 1ml dose, were getting a shot of 5000 or 10k IU’s? All at once? I am guessing so, seeing as you were seeing a “reproductive specialist”. I think he dosed you like a woman, which would really jack you up. You E2 would be sky high real quick, and your T would not. I think your doc may be an idiot. I’m channeling @systemlord here, I know.

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No not too well at all. My dose is 25mg a day.

I will ask them about enclomiphene

Is it typical to start out rough on clomid and then later improve?

I’m not familiar with blood tests from the Internet, how do those work?

My next labs are in about 2 weeks.

I’m not sure on the dose, all I remember is 1ml a week.

Yea that’s kinda what I’m thinking because my estradiol was 37 and testosterone was 441.

I definitely feel jacked up. Not sure if it’s due to high estradiol or low T or both.

You could try cutting your dose in half to 12.5mg just for a while to see if your body gets uses to it. That said 25mg is a pretty standard dose. The side effects are pretty well known. Here’s hoping your doc knows them and offers enclomiphene.
Google discountedlabs and see what comes up.

They’re switching me from clomid to Anastrazole.

Doc thinks depression is a side effect of clomid and not because of higher estrogen levels.

When you find it online is it from a research peptide company or online pharmacy? I was able to find one pharmacy but was hoping to find others to compare prices to but no such luck. Mostly came up with stuff on the HCG diet when I tried googling. Maybe just need to dig deeper into google.

I agree clomid can make you depressed. I don’t understand the switch to anastrozole. That will reduce your E2 and that’s about it. If he gives you too much he will crash your e2 then you will really know what depressions is. You need your E2 lvl. before taking any AI.

Doc switched me to Anastrazole because he thought my horrid depression symptoms were a side effect of clomid.

He prescribed 1mg Anastrazole daily.

I’ve read a few different articles about how it can raise testosterone while lowering E2.

I’m willing to try anything at this point.

My estradiol was at 37 about 3 weeks ago.