T Nation

Fixed ED Issues, But Why?


#1

Hello, I've been on TRT for almost a year now and have struggled with ED up until I added HCG to my protocol.

My Protocol - (Thank you KSman)
.25ml E3D of testosterone cypionate 200mg = 100mg/week
1/4 Arimidex EOD = 1mg/week
250 units of HCG EOD = 750ui's/week

I've been on HCG for 3 weeks and I feel really good. I know HCG mimics LH and makes your sack go back to normal size and start producing testosterone again, but is that it? I don't really care much about how big they are or being fertile. I have 2 kids and have gotten a vasectomy. The reason why I ask is because the compounding company is charging me $125 every two months, and this is a little too much for me. I want to know what else happens to my body when taking HCG and if there is a less expensive alternative to curing my ED. I have tried Cialis and Viagra, yes they do work but cost about the same. I have tried ordering online in the past and have had nothing but bad experiences. Any help would be great, thank you in advance!


#2

250iu EOD should last 80 days for a 10,000iu vial. You can get cheaper from a compounding pharmacy and they can mail out to you even if out of state. Will come with B12 in it too. mwcpharmacy.com

All of your calculations are fuzzy.

You need these labs: if you have these, post with ranges, otherwise try to get others done.
TT
FT
E2
PSA if over 45
TSH
fT3
fT4

Please read the advice for new guys sticky and post more info about you.
- note first paragraph

Many report an improvement in mood [nervous function] with hCG.


#3

You're taking a lot of Adex for not a lot of TCyp. Do you have sensitive E2 labs to support that dosing? That's a powerful dose and it's a fallacy around here that that should be standard practice for men, this .25mg EOD dosing.


#4

My guess is that your ED was cured because the Hcg increased your T, perhaps as much 500 ng/dl. I've pasted a summary of a study I recently read when I was looking into this. If it were me, I'd go with Hcg over viagra or cialis any day. Best of luck.

"Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression?"

This was a 3-week trial. Baseline for all groups was 407 ng/dl (with an intergroup range of 355 to 441). The average age was 24 (range 18-41).

Everyone received weekly IM of 200mg T enanthate throughout the study. The participants were then split into four groups to test the effect of adding HCG. The Hcg doses were 0 IU (placebo group) 125 IU (EOD), 250 IU (EOD), and 500 IU (EOD). Unfortunately, exact serum T levels are not disclosed (as far as I see), but they are charted out on a graph so you can estimate pretty closely.

The results at the end of the third week were as follows:

IM 200mg T enanthate
plus 0 EOD: ~779 ng/dl
plus 125 EOD: ~750 ng/dl
plus 250 EOD: ~1295 ng/dl
plus 500 EOD: ~1270 ng/dl

I can't tell when blood was drawn in relation to enanthate injections, so it's hard to know whether the results were during peaks, troughs, or in between. But the takeways for me are:
- 125 IU hcg EOD didn't increase serum T at all (when taking enough T enanthate to shut down natural production)
- 500 IU EOD didn't increase serum T any more than 250 IU EOD.

The focus of the study was on spermatogenesis, which I couldn't care less about, but as far as serum T, this study supports the use of 250 IU hcg EOD.


#5

Thank you Sir for your reply. I did get a 10ml vial but it says to discard any unused HCG after 60 days. I called mwcpharmacy.com yesterday and they told me that it was $65.00 for 10ml vial, which is a really good price compared to the $125.00 I am paying. What kills the deal is the shipping, they need to overnight it to me and it costs $62.00 to ship.

I told them that I didn't need it to be overnight and would like to receive it dry. They told me they do ship it dry but they can't ship it any other way. I need to wait at least another week to get another lab done. I will post results as soon as I get them.


#6

On the last lab that was taken 9/30/14 these were my numbers.

Estradiol - 35 pg/mL (range 7.6 - 47.0 pg/mL) normal but I wanted to be under 30
Testosterone - 1163 ng/dL (range 300-1080) This was high but was taken 2 days after shot
Sex Hormone Binding - 14 nmol/L (range 11-80)
Testosterone, Free - 339 pg/mL (range 47-244) This was also high

I don't know if this means I am sensitive, but I've been reading here that 22 pg/mL is where I want to be.

I was taking .75ml/week of adex when this was taken. .5 the day after the shot and another .25 2 days later.


#7

Thank you for this! Like I said I don't really care how big my sack is or being fertile. Do you think just adding a little more testosterone will produce the same results?


#8

The 22 pg/ml target you're referring to is on the sensitive E2 assay. The test you had done is the standard assay, which significantly overstates E2 values. Your E2 Is likely too low already.


#9

Probably, though I have to admit to being pretty uninformed on other things that hcg does that may affect your mood or libido.

Do you know what your hormones were at before adding hcg?

For hcg costs, I don't think that ordering overseas for a lower cost is in itself a problem. I think the problem is when people do it without having a legit prescription. Pretty sure there is a limit on how much you can order at a time; it may be just one month's supply, could be three months, I honestly don't know, but worth looking into since cost is the issue.


#10

Has this been confirmed? I recall some debate about which version of the test is the one to go with, but I think the Lab Work sticky still recommends Labcorp basic E2 and the Quest Sensitive (but not UltraSensitive). Sorry if I missed a post laying this out in more detail, but I've used the Labcorp basic and would certainly like to know if that one overstates E2. Thanks.


#11

Absolutely been confirmed, a sensitive test is far more accurate than a standard test. The standard test frequently overstates E2 values by 20-30 pg/ml...sometimes more. The sensitive test is designed to measure the low levels of E2 in men.

I have both the standard and sensitive test done on each round of bloodwork. I've had standard values in the mid thirties while the sensitive value was in single digits.


#12

Not for me. From my bloodwork, the sensitive assay under reports E2, leading to an AI overdosing.


#13

Why would you take more of an AI because of a lower E2 value?


#14

My fault, meant to say under dosing. I feel much better with my E2 in the 20s on the regular assay. Weight loss is also easier.


#15

lgs, You're sweet spot may be different as everyone's can be but the ultrasensitive test is definitely more accurate for men even the lab will tell you that. I used the sensitive test on 2 0f the last 3 test and they ran regular on the last one and my levels were 33, 44, and then 105 with the regular test so it really makes a difference. everyone just needs to find their sweetspot and 22 is a good number to start with.

filo, One thing that the hcg will help with besides what you have mentioned is your mood and well being. It effects your brain when you are shut down so it is a little different that just adding more T.


#16

I agree with Ironman, everybody's sweet spot might be a little bit different. The "goal" range seems to be 20-30 on the sensitive test for many guys, but that doesn't mean that it's wrong if you feel good above or below that range. Some guys seem to feel better with higher or lower E2.

It's a cliche/blanket statement to say this, but everybody responds differently to certain hormone levels. Just gotta find out what works for the individual.


#17

I agree, individual variances are there. Also, you are correct that LabCorp regular test is too unreliable. Since that I have switched to Quest whose "regular" assay is very steady on my tests. Results come in exactly as I expect based on my AI changes.

With that said, I still think LabCorps sensitive assay under reports but hey, if you feel great with 22 on sensitive, go ahead. Numbers should only be a gauge, not a goal. How you feel is ultimately what you should chase.


#18

Thank you so much for all the input! I hope I haven't been overdosing on AI. I'll try to request for a sensitive assay on my next lab.

After adding HCG I did notice that my mood is better, even my co-workers noticed this. I also have noticed that my penis is more sensitive and I think having lost the sensitivity is the reason why I couldn't keep an erection. Maybe this is just a placebo effect.


#19

Sorry for the delay on labs. I wanted to wait a little bit on getting labs because I made some changes to my protocol. Three weeks ago I switched from injecting testosterone IM to SC. I have also dropped down Arimidex to .5mg/week. I'm not sure if the HCG's effect has lessen because I can feel that ED issues are slowly coming back again.

TT = 1014 (range = 300 - 1080 ng/dL)
FT = 310 (range = 47 - 244 pg/mL) - HIGH

E2 = This test was sent out, and I'm still waiting. I'm hoping my doctor sent out the right test when I asked for a sensitive E2 test. It says "Estradiol by TMS" is this the right one?

TSH = 2.610 (range = 0.300 - 3.700 uIU/mL)
fT3 = 3.8 (range = 2.4 - 4.2 pg/mL)
fT4 = 0.94 (range = 0.53 - 1.43 ng/dL)

Here are a couple extra things he ordered that came back low or high.

MCHC = 33.5 (range = 33.7 - 35.3 g/dL) LOW
Testosterone, % Free = 3.1 (range = 1.6 - 2.9) HIGH
Sex Hormone Binding = 10 (range = 11 - 80 nmol/L) LOW

Thanks in advance for the help!


#20

ED is common when testosterone is too high. Reducing your doses will probably improve ED problems.

Your SHBG is too low. Since androgens depress SHBG, it is likely that your SHBG will improve if you lower your T dose. Low SHBG is associated, among other things, with diabetes and metabolic syndrome, so you don't want to have SHBG low.