T Nation

HCG, Aromitization, and Leydig Cell Desensitization


I will be starting HCG injections this weekend (1,000 units every other day) as treatment for low T. I already know that the higher levels of T will also cause higher levels of E2 due to aromitization, and I also know that with HCG comes the risk of desensitizing the Leydig Cells.

Researching the solutions to both problems, I see than an AI like Anastrozole can keep the E2 levels down, and a med like Nolvadex (Tamoxifen) can prevent HCG-induced Leydig cell desensitization. However, I've also read that patients taking anastrozole or letrozole should not take Nolvadex, as serious interactions could occur.

So if you can't take both at the same time, is there a known way to combat aromitization and leydig cell desensitization at the same time, while taking HCG?


That's a pretty high dose of HCG - at that amount (anything over 500 really) - you risk desensitizing the Leydigs. Back that down to 250iu EOD, or 100iu ED (that's the standard protocol for TRT guys, anyway) if you are going to be doing this for a while. There are some protocols that call for 5000/3000/2000iu "restarts", however. You MAY need an AI with your dose, you may not. You do not want to mix a SERM (chlomid/Nolva) with HCG use.


Do you guys have an literature on leydig cell desensitization? From my research, it is mostly bro-lore.


"Desensitization happens with much larger doses not extended use. HCG, as an LH analog, in smaller physiological doses will not desensitize the leydig cells. Therefore, there is no need to cycle HCG."

This study of two people did not show issues after 23 months of high doses: http://www.eje-online.org/content/53/2/315.short

This study showed no long term reduction in efficacy:

"Small, daily shots of HCG produce the most physiologic ("normal") hormonal milieu. It also helps backfill the pathways. This is why men do better on it. And injecting in the morning provides for the increased sense of well-being, and libido, HCG brings as it binds to the LH receptors in the more peripheral (emotional) centers of the brain, that you can then enjoy all day." - Dr Crisler


I'm not sure what specific dosages are being cited here. I know that professional opinions differ on how high the dosage can go before you put the Leydigs at risk. I told my doc I'm only willing to go as high as 500 IU every other day, so I've started off there and may drop even lower, depending on what the tests have to say in a few weeks.

It seems the important number to determine is the dosage above which there's no added benefit, and what risk that dosage poses to the Leydigs and as far as aromitization, if any. I've read some hot debates between professionals on what that number is, but as with most things I imagine it varies from person to person, and needs to be found through cautious trial and error.

As for Dr. Crisler, even though I'm injecting every other morning instead of every morning, I can vouch for the psychological benefits. I started feeling noticeable, lasting improvements after my 3rd injection.