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Doctor Starting Me on 160mg Test/Wk, 500iu HCG, and AI. Thoughts?

Just found this place and hoping someone can help me out. I am 39 years old and since i was 17 been involved in sports and training. I competed at very high levels until my mid 20’s. I am 6ft3 230lbs and workout 2-3 hours 5-6 days a week. Over the last few years my sex drive has been close to zero. If i give myself time to unplug from work, training and athletics I have no problem getting and maintaining an erection if needed and still get the occasional morning wood. I also find myself sleepy during the day no matter how much sleep i get.

I decided to look into TRT out of curiosity and got my blood results back. My total T was 600, Free was 18 or so, Estrogen 32, DHEA 299. Thyroid was good and i had a high SHBG 66. The doctor analyzed my results and was concerned because i had a high LH of 8.2. He had asked me about testicle trauma, drug use etc… which i never had any trauma and never used drugs.

He said this pointed to primary hypogonadism and my brain was sending a signal to my testicles to produce test but they were shutting down? My first question is does this sound like primary hypo? My test was 600 and free 18 with a high SHBG. I have been down since hearing this almost wondering why my boys are quitting on me.

Next he prescribed me 160mg of testosterone a week, and 500 IU’s of HCG with an AI. I have not started yet because i figured i would ask you guys what you think about this protocol and if i even need it ? Thanks guys !

I’m learning also. I mite not be any help like some of the experienced guys but what AI and dose did he give you.

What are the ranges on your labs? IMO with those numbers you don’t need TRT but can’t say for sure without knowing your ranges.

It would be helpful if ranges were provided, hard to tell if these ranges are labcorp or some other lab range, but saying Free is at 18 doesn’t really say much in a world where every lab company uses its own ranges.

You do not have secondary hypogonadism indicated by your Total T at 600, your liver is over producing SHBG which is then binding up the majority of testosterone forcing the pituitary to respond appropriately by increasing LH to compensate.

Primary hypogonadism is very high LH and low testosterone.

High SHBG can be genetic or from extreme dieting/calorie restriction.

Low thyroid hormones share the same symptoms as low testosterone. Testosterone is metabolized in the liver and thyroid hormones is responsible. A thyroid panel is recommended.

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What kind of working out are you doing? I doubt that you have any form of hypogonadism, honestly. You might be suppressing your levels through the physical stress of the workout load, which is not a bad thing in and of itself.

This would point towards stress and maybe a sleep issue. Have you been checked for apnea? Do you sleep through the night, or do you get up to pee a couple of times? How’s the diet?
Not taking it is a smart decision, you need to get other things checked.

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Hey @Sprinter528…not sure if this is a faux pas here or not but…was this a doctor from Defy? A Doc from Defy told myself and 1 other guy I’ve seen online the exact same thing.
High SHBG does not = Primary Hypogonadism. It’s either ignorance or negligence on the doctor’s behalf, neither of which is acceptable.

Edit: That is also the exact same protocol this specific Doc has been passing around.

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I had some the same T levels as you but a more normal SHBG (38) and got on TRT because I wanted my T to be higher. In all honesty I don’t feel much different as far as every day feelings go. I think the guys with the 200 total T levels are the ones that take TRT and feel the fountain of youth but it’s likely you won’t have any crazy change. Putting on and keeping muscle easier is a definite plus and for me worth it especially since I’m about to be 36 and would be on TRT eventually anyway. It’s not all roses though. Getting dialed in was a pain and took a while to figure out and though I feel good I could probably feel better. Many people on here complain about having to take 30 secs - 2 min to do a shot twice a week and I’ve never understood that personally but you see it quite a bit. If you are younger I would probably say wait a while before getting on TRT if you are just doing it to do it. I’m happy with my decision though.

Thank you all !! the ranges for test were 264-916 for normal, Free test 8.7-25.1 for normal, Estradiol 8-35, and LH 1.7 to 8.6.

Systemlord: What would classify as very high LH ? The Doc said 8.2 was bad news but it seems that for primary hypogonadism it would be much higher with a very low total test number correct ? I have been on a very restrictive cutting diet for the last 2 months.

Hardartery: I do about an hour a body part and so 5 days a week chest, arms, legs, back, shoulders with abs and then about an hour of cardio. Saturdays i do kettlebell workouts. I do sleep through the night… my fiance actually jokes that i run myself into a coma. I sometimes just pass out on the couch and wake up when my cell phone alarm goes off.

Zedsdead: You guessed right did you also have a high normal LH ?

Dexter: My primary reason for TRT was to take my levels back to when i was in my 20’s. So i think we are similar. I never felt exhausted or run down and was hoping this would help me recover faster and feel that insane energy i did back then. What does TRT take your levels to ? I am curious if it would even be that much of a difference. Would 160mg a week raise the test to 1000 or would it be like 750-850 ?

That’s too much as a natural, especially a natural that’s almost 40. The hour of cardio could actually be hurting you T levels quite a bit, depending on what you’re doing. I don’t know your intensity or anything, but you’re overdoing the lifting. 3 days a week will give you better recovery.

I stand by what I said, that I don’t believe you need TRT with those numbers and will not feel much different with TRT dosages. I could be wrong though. I feel if you adjusted your workouts you would feel far better IMO. I believe it is too much especially if you have been on a cut. You should be in and out of the gym in an hour to hour and a half at most otherwise it is just detrimental to progress

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Above range LH, you’re right at the top if I’m not mistaken. Didn’t see the ranges listed.

This is likely the reason for your high SHBG. We see this alot where in the attempt to manipulate our bodies we are causing harm.

Another scenario is a guy who skips meals over a long period of time do to long work hours, add poor sleep and now you have a recipe low testosterone and high SHBG.

Systemlord 8.7 is the end of the LH reference range accepted normal.

So you guys think I should hold off on starting. Get my sleep and diet more in check ? During the summer months I am often running rampant. Wake up at 330 Workout until 530-6… go to work and get home and practice or play golf. Or do you think with my lifestyle I need the TRT to maintain it ? I can cut down my workouts but I will always be insanely active.

hardartery made an excellent point about your excessive 2-3 workouts, eat plenty and take it easier for awhile and maybe T will increase.

Sleep is another big factor in T levels, hormones are replenished in stage 4 REM sleep. Running isn’t healthy as people believe, it’s hell on your body.

Sleep is critical. I worked nights for 3 years straight, I averaged 4 hours a night, and I would often just not sleep after my last shift for the week - I would stay up all day with the wife and then go to bed at night when she did. It shortened my life.

I agree i have gone overboard with working out. One of the downfalls of having a full gym in your house. When your bored its easy to go jump on the treadmill, elliptical or lift. I definitely know better and my calories have been insanely low. I stopped seeing the body fat come off so i kept lowering calories and increasing my workouts. I actually remember having even less of a sex drive when i was younger and over trained.

For the last 3 weeks i have been using magnesium, boron, and a supplement called testosterone up ( has a ton of ingredients for lowering SHBG), I upped my vitamin d to 5000mg a day and increased my fish oil. In the last week my sex drive has gone through the roof. I have also woken up with morning wood every morning for the last week. I have not touched any of the TRT supplies they sent me. Is this a sign that my SHBG may be lowering and free testosterone rising ? I am not trying to sell any products but when i realized my SHBG was high i googled ways to lower it and these supplements and several scientific studies popped up so i figured i would try.

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Seems possible free t is rising. Hopefully that’s all you need!

After some debate I am going to start trt. My reasons are I am going to be 39 and will probablly continue to decline over the next few years. I am a very active person and having optimized test levels are desirable. My question is should I inject twice a weeek at 80 and 80 or to avoid potential estrogen rises try 3 times a week? I am a high shbg guy.

Also running hcg on trt. Would it be better to go 250iu every other day or stick with the 500 iu twice a week at time of test injections?

500 IU twice a week would probably be better for the HCG, but you’re probably better off not starting not with the TRT. Better to get a handle on one thing at a time. See how you react to your dose, do your dialing in, then move on to the HCG and see how that goes for you. You may or may not like HCG, so don’t fixate too much on using it unless you’re trying to make babies.

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Sounds just like a Defy protocol