T Nation

Gonadorelin to Replace HCG

What the title says. New here looking for advice. My current doctor because of hcg not available, wants to put me on gonadorelin with my original protocol of 200mg of testosterone. does anyone have any thoughts on this or any experience with gonadorelin?

No direct experience, indirectly only with anovulatory women. Is it expensive?

By the way, hCG is available, it is just not allowed to be made by compounding pharmacies.

After doing some digging since a clinic i know is no longer using hCG, a called a few pharmacies and found out they are going to be offering Gonadorelin and NOT Kisspeptin. Kisspeptin is a peptide and it is NOT approved to be compounded and states like California will not approve it, while Gonadorelin is allowed to be compounded. Does anyone have any input on this?

Gonadorelin is a branded synthetic version of GnRH. It’s been commercially available since the early 80’s under various brand names. Honestly, I don’t see how it can be logistically incorporated into a TRT protocol. GnRH requires pulsatile infusion otherwise there is rapid down-regulation of GnRH receptors on the pituitary. I did my master’s thesis on this topic many, many years ago.

I’ve read of some fertility protocols where men or women (depending on who is infertile and why) use portable infusion pumps to pulse GnRH into the subcutaneous tissue, but this requires a lot of motivation and is not intended as a long-term treatment.

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Gonadorelin cannot be used successfully by itself as a replacement for hCG for men on exogenous testosterone in the fashion I am seeing it done by guys posting on here. In addition to the excellent summary by @youthful55guy on the need to pulse a gnrh agonist 4-8 times a day, there’s also the negative feedback issue. Clinics that are doing this are basically stealing from their clients and committing fraud. If they are doing this out of ignorance, then clearly you don’t want them treating you. I just started reading all of these posts about guys taking gonadorelin twice weekly while on exogenous test. See here:

Print out this diagram and go to your provider and ask her/him to explain to you how infrequent injections (twice weekly) of gonadorelin will stimulate the pituitary to make LH while also under the negative feedback of estrogen (from the aromatization of exogenous testosterone):

Unless your provider is incorporating a SERM (to antagonize the estrogen at the pituitary level) and having you inject gonadorelin 5 times a day along with your Testosterone injections, there’s a very good chance (I’ll throw out >99.9%) that you are flushing the money you are spending on the gonadorelin down the toilet. Ever tried to drive a car hitting the brake and gas at the same time. That’s what this gonadorelin + testosterone protocol is doing. The negative feedback from estradiol is going to win this fight unless you also properly add in a SERM.

Some additional reading:

@lordgains, @unreal24278 figured you guys would enjoy this. What’s your take?

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Exactly what you said. GnRH needs to be given multiple times per day. If an agonist is given chronically, you’ll go from the “flare up phenomenon” to 0 LH and FSH as seen in cancer patients receiving GnRH agonists. (Interestingly Agonists (Superagonists) get used instead of Antagonists because the shutdown from an agonist is reliable). If it is given frequently that’s a procedure that’s done with boys with delayed puberty or absence of a working hypothalamus, so it can work but not in conjunction with T. The doctor should seriously be questioned about his knowledge or I’m missing something.
I know this for a long time now, what really shook me was the research you provided on nasal testosterone application and the subsequent absence of suppression.

Back to the topic: As you said -
The research you posted indicates indirectly that if you’d take a SERM to block E2 receptors at the pituitary level, you could pulse GnRH to uphold natural levels of LH and FSH and subsequently fertility if you’re on exogenous T. I don’t know why but my gut tells me that won’t work. I’ll try to look at some papers and post my opinion when I find the time in the next days.

Thanks for the review @lordgains! If you go over to Excelmale and search for @cataceous and “pituitary restart” you can read his experience. Shows promise but you have to be “criminally insane” (as @iron_yuppie calls it) in a scientific way to try it. I like that @cataceous’ style.

I hope you are doing well.

Yes I am, currently finishing the pharmacy days up. Hope you are doing good too.

I read it and he really does a good job of experimenting scientifically. He’s right about the pump in the future. One of my problems with TRT (though I’m probably gonna be on some day) Always was that I don’t think that GnRH, LH, FSH are useless besides T and sperm production. Very interesting that the addition of a SERM really works that good. Shows that the research is right in this. No T receptors in the pituitary.