T Nation

Dr Prescribed 200mg/Wk, Says It Wont Affect LH/FSH. Refused HCG

  1. How long will it take for LH and FSH to go to zero so i can convince him to let me take hcg as well?
  • He doesn’t believe trt doses will suppress it and it is pointless. when i argued, he cited my high hemoglobin as the biggest reason not to put me on hcg as i could get a blood clot.
  1. Should i take this very large dosage of 200mg a week (split into two doses) ? or just go ahead and just take 100mg (50mg 2x a week)?

SHBG 14 nmol/L (10-55)
Testosterone 8.8 nmol/L (8-29)
Free Testosterone 263 pmol/L (175-700)
Estradiol 14 pmol/L (0-44) (non-sensitive)
Hemaglobin 176 g/L (137-180)
Hematocrit 0.54 L/L (0.4-0.54)
RBC 6.2 (4.5-6)


TRT definitely suppresses LH and FSH.

Your gonna be in for a ride if you inject 200mg at once with that low of a SHBG.

Most start at 100mg a week, and then you can adjust from there.


How long does suppression of LH and FSH take from TRT? I still have some hcg left over from a few weeks ago, if i take that will it suppress my LH and FSH further (or is exogenous testosterone the only factor?) so i can show him my low LH and FSH?


LH FSH will be near 0 pretty quick. Probably a couple of weeks.

HCG will not raise LH or FSH. It mimics LH and bypasses pituitary and works directly in testes


Depends was you’re cause of hypogonadism primary or secondary. If primary gonadotropins won’t be suppressed to 0, nor will HCG be of any benefit.

Secondly, SHBG has nothing to do with injection frequency, dose perhaps, but not frequency. 200mg is a large dose to start off with but it is by no means ridiculous. Try it, get bloods, reassess

Trt will raise H@H further, go donate some blood, a HCT of 54% isn’t particularly dangerous for a healthy male however you’re doc may not be happy with it. Were you dehydrated at the time of testing?

If worried about fertility… Freeze sperm.


Blood clots form when you have a certain type of disease, TRT doesn’t cause blood clots in the absence of these specific diseases. A lot of doctors treat high HCT levels as polycythemia vera because they have zero knowledge in TRT.

You may very well have problems with free estrogen do to low SHBG and HCG may only cause more problems with estrogen conversion.

You need very small doses ED or EOD in order to keep free estrogen from getting out of control.


Agreed with the above - 200 is too much especially with your low SHBG, LH and FSH will be suppressed a couple weeks into exogenous T being detected. If you don’t absolutely need fertility why complicate things with hcg… as for H&H I would first assess diet, exercise lifestyle factors, family history before pointing the finger at T.


So I decided to start with 120mg a week rather than 200mg. Hopefully the doctor doesn’t get pissed.

After my 3rd shot of 60mg (week 2 injection 1/2). The next day in the morning i was rock hard and libido was up. But that all disappeared by the evening that day. I have also been sleeping more than normal. I also had a massive headache a few days after my shot (related to any of the hematocrit, rbc etc above?)

  • Do you think my E2 went into the ideal range and then above range? (there is no sensitive E2 test in my province of Alberta in Canada)

my current symptoms are slightly sensitive nipples to the touch, rubbing them feels strangely good
- sleeping more than normal, more tired than normal
- low libido, soft erections, ED, Lackluster orgasms

  • Or do you think because of my low shbg the T just got metabolized too fast?


Everything will fluctuate at the beginning. You need to stick it out and see how things are in 6 weeks.

You will have your ups and downs (no pun intended haha) during the beginning.


Happened to me too. Not so much now. They still feel good. But when super sensitive I can ejaculate real quick with nipple play and jerking.

My wife likes to play with them in general sometimes I tell her to stop or her fun would be over quick. Lol


Your testosterone and estrogen levels are swinging and haven’t reached a stable state which takes 6 weeks, so until that time you will have good days and bad days. As you get closer to 6 weeks things may start to feel more consistent.

I just started a new TRT protocol and am going through the same thing.