T Nation

HCG IM or SubQ? Still Have Low LS/FSH. Test Level Too High?

Ive been taking HCG for about three months now. Had Dr add it so I can get my balls back.
Ive been injecting it IM this whole time. Just got labs back and my LH and FSH are basically zero
LH: < 0.1
FSH < 0.1
My Total test is high 1,159
Free T 30.97
SHBH: 29
Estradiol: 43.4 (I had dr prescribe me some arimidex to drop this down)

Anyhow Im thinking of dropping my Test dose as that total number is high, way higher then I need it.
Ive been on 200mg Test Cyp once a week.
Im thinking of dropping it down to 100-120mg per week to see how my numbers react before taking an Arimidex.

Dr thinks that my LH and FSH are still zero because Ive been taking the HCG IM instead of sub q. Could this be that big of a deal?

I know guys say .25mg every 3 days for HCG but Ive been 0.5mg once a week

To me, these are optimal. Why change it? Don’t get stuck in this “too high” bullshit. HOW DO YOU FEEL?

Leave your Estrogen alone. High E in the presence of High Test is fine. If you having nipple issues, then maybe consider Nolvadex to prevent issues.

You’ll see a lot of differing opinions on this subject. But our resident Endo/BBer/TRT Doc says this:

Protocol may not be optimal for you, 50-60mg twice weekly is more common, large infrequent doses can increase aromatisation and increases estrogen and increases the need for AI’s. Frequent dosing can lower estrogen and eliminate the need for AI’s altogether.

Frequent dosing can also gain control of CBC levels across the board therefore eliminating the need to donate blood which if you’re not careful can deplete ferritin in some men.

HCG is supposed to be injected SubQ, not IM. HCG doesn’t increase LH, it mimics LH and suppresses the top half of the testicles. AI’s cannot affect E2 produced inside the testicles.

TRT is supposed to suppress LH and FSH to near zero as TRT shuts down the HPTA pathways while you are on TRT. Your doctor doesn’t seem to understand TRT shuts down LH and FSH production, not surprised at all as we see a complete ignorance in the majority of doctors related to TRT and sex hormones knowledge.

FSH injections can increase sperm production dramatically if trying to have children.

After posting that I thought about it and thought basically the same thing you posted. I feel great and Im having no signs of high estrogen.
The only thing I might change is injecting twice a week instead of 1.
In reality I dont even inject every 7 days, I always forget. Lately Ive been pretty good and inject every Saturday, but I was usually around 7-10 days.

thanks for that reply. Yes my Dr is not very aware of TRT but she is actually trying to be and she listens to me and will prescribe me what I ask. She even admits that TRT is not her specialty but says shes really trying to get more involved in it.
my blood is right at the top max of normal and she encouraged me to donate but I think Im going to try the biweekly injections like you suggest and see how it responds

As mentioned, hcg does not stimulate/increase LH and FSH, it suppresses it.

Hcg is typically sub-q but as mentioned, hcg whether sub q or IM suppresses our LH and fsh. This is a big read flag of an incompetent doctor.

You’ll need a serm like Clomid or nolvadex to potentially raise these two markers.

If I were you, I would drop your T dose to 50 mgs twice per week. Your estrogen will likely get cut nearly in half and an AI won’t be needed anymore. The less chemical load the better.

Is fertility a concern? If also start looking for a competent dr.

You should definitely pin twice a week.

It’s rare to find a doctor that is open minded and admits lacking knowledge in a particular field of medicine, a lot of doctors let pride or arrogance get in the way.

An open minded doctor has great potential, stick with this doctor.

yes Im definitely sticking with this Dr. Shes very laid back and honest. She will tell me straight up “I dont know about that, I’ll have to do some research”.
Shes not an endocrinologist but is very good about thyroid issues (I had a thyroidectomy due to cancer) She understands that “normal” blood work doesnt mean everything is good and goes by how I feel. I had to drop my initial Endo as he ONLY cared about what my thyroid labs said and would ONLY prescribe Synthroid (T4). Every time I asked about T3 as supplemental he said NO!
Ive been taking T3 with my T4 and feel 100% better because this Dr listens and will try things.

Im not going to drop my Test dose in half from 200 to 100 but I might drop it to 150mg and pin 2wice a week…thanks for replies.

Im 41 and have 2 grown sons. Fertility is a non issue for me at this point.

Some doctors believe T3 medication is unnecessary (common in UK) as if people don’t have conversion issues, some can’t unlearn what they have learned even if it’s wrong. You give a guy T4 only who has high Reverse T3 and it’s a disaster, it only shoots Reverse T3 higher do to a conversion problem and the patient feels worse and doctor won’t listen.

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After you reduce your T dose, if your e2 is still high or youre not feeling optimal, you may want to try dropping the hcg. Some men feel worse taking hcg, me being one of them. You could go with Clomid or nolvadex to supplement it’s absence.

Part of me agrees with you. It could certainly be worse. He could on the other hand have a competent Dr that didn’t require their patients to educate them.