T Nation

HCG as Monotherapy for Secondary Hypogonadism

Hi there,

I have been on TRT for the last 9 months or so. I am a 27 year old with secondary hypogonadism . I am not a science guy and do what the doc tends to tell me. I started out taking Testosterone Cyp, injecting 0.5 ml once a week from a 200gm/ml vile…not even sure what the dose is!

I combined it with HCG 2,500ui twice a week (if that sounds right.)

Switched doctors, moved to the UK; everything is different here. The doc took me off the Test. as my RBC has tended to fluctuate; the Heamoglobin 174/176 g/L. They switched me to Androgels for a month…totally ineffectual for me and my Test levels went from 31 on injections to 10 (prior treatment i was 1.2-2).

How high are these bloods? Are they likely to be a worry if i stay on T? If I did stay on Test. would switching to a different ester impact the RBC?

The doctor wants me to be on HCG mono-therapy. I am open to the idea. I am however, curious as to why some doctors totally reject the idea of HCG mono-therapy and favor it only when combined with Test. when fertility is a concern. For me, fertility is not an issue. I just want to feel well, and after 4 weeks of renewed low T symptoms that were only getting worse, I dont really want to play the game of waiting another month here and there.


You should never inject more than 500ui at a time, at this dosage you are asking for a ton of negative symptoms such as bloating, water retention etc. More practical dosing for HCG is 100-150 daily, 250 EOD and 350-500 twice weekly

You can combine HCG with TRT, whoever said you can’t doesn’t know any better.

T gels are usually ineffective at getting testosterone levels where they need to be. A 10 nmol/L Total T is considered low-T, the endocrine society defines low-T below 300, but studies show anything at or below 440 ng/dL (15 nmol/L) to be linked to cardiovascular problems.

You want your levels between 22-25 nmol/L at a minimum. What your doc should have done is lower the dosage which usually does the trick to lower HCT since it’s the androgens that are increasing the hematocrit.

Balance My Hormones in Dorset which is a private clinic that you could use to manage your TRT if you find your docs unhelpful. The UK medical system is generally really bad at treating men with low-T.

You were injecting 100mg testosterone a week, typically a low amount, but you were also using hCG.

5000IU of hCG weekly is a common dose (even up to 10-12k IU) when used for fertility purposes. It’s a lot for TRT considering it would be long term. Obviously, I can’t speak for your doctor’s thought process. When used in combination with testosterone, 700-1000IU a week is almost always sufficient to maintain fertility and testicular size.

You won’t find many fans of Androgel here. Sure, a lot of men use it and are fine using it, but they are not here. Generally, it is inconvenient, poorly or inconsistently absorbed, expensive and has a high risk for transfer. I’ve seen women come in for HRT expecting to be given testosterone, only to discover they already had high levels from contact with their husbands.

Erythrocytosis is rarely a problem whether due to living at altitude or TRT. Your Hgb is fine. If it becomes an issue, lowering the dose a little and increasing injection frequency can help. Individual response to the different esters could impact RBCs, but it is doubtful and not at all predictable. Maybe worth a try, I’ve seen it.

I can tell you why some doctors do not favor hCG mono-therapy. Low testosterone is the problem and it is easier and makes more sense to restore testosterone levels directly. Men make very little hCG and while some may think hCG produces “natural” testosterone using the very high dose (compared to what we normally make) of hCG needed for this purpose is anything but natural. Over the long term, there will be its own negative effects as we are not supposed to have that much hCG in us.

Good luck moving forward. Taking testosterone is the best thing you could do in your situation.