T Nation

HCG Mono Issues


#1

Long story short...for the last year at least I was feeling really off. My endurance was extremely low, intensity during workouts was almost always low, had bad anxiety, and low libido. Regular labs all looked fine except a slightly elevated A1C. Finally asked to pull testosterone and found out I was very low. Fertility is a concern right now, so I'm trying to make an HCG Mono protocol work, but I'm really having a tough time dialing it in.

Here are my initial labs:

PSA - .26
Free T4 - 1.0
Cortisol - 14.4
Iron - 104
Test Total - 180
Test Free - 44.5
Test BIO - 89.5
SHBG - 12
Albumin - 4.4
LH - 1.3
FSH - 1.7
PSA - .26
TSH - 1.77

Age: 33
Weight: 198
Height: 5'9"

Started at 400iu EOD. The first two weeks were really great - libido in particular was better than I can ever remember it. But then near the end of the second week, things started to decline.

Got labs at the end of the third week:

Testosterone Total - 545, Range 241 - 827 ng/dL
Estradiol - 51, range is 21-41

By the fourth week, I continued to feel worse and worse so around the 5th week, next set of labs:

Testosterone Total - 385, Range 241 - 827 ng/dL
Estradiol - 52, range is 21-41

So from here my endo asked me to up my dose to 1000iu EOD and added in 1mg of arimidex daily. Knowing from the forums that 1mg is way to high, I've been doing .25mg EOD and taking it on injection days. I've been on this increased dose hcg and AI for about 7 days now.

Bottom line, I feel pretty horrid. I can't sleep, and most of my initial symptoms before starting hcg mono are back.

Any thoughts on my labs and protocol suggestions? And here I thought this was going to be easy!


#2

too much hCG and T levels still low

hCG mono is not going to work for you

hCG causing high T–>E2 conversion rates inside testes and anastrozole CANNOT reduce that!

Your higher hCG dose making things worse.

Your TSH is getting high, better close to 1.0
Have you always used iodized salt? [or deficient]
Check your oral body temperature when you first wake up AND in mid-afternoon [BOTH]

  • read the thyroid basics sticky

Labs:
prolactin
TSH
fT3
fT4 [please not T3, T4]

You have secondary hypogonadism and testes are not responding well to hCG.

You may need:
100mg/week T cyp/eth injected twice a week
1.0mg anastrozole per week. 1/2mg at time if injection
250iu hCG SC EOD to maintain testes and fertility


#3

That’s what I was thinking too, but when I brought up adding T cyp to my endo he just about laughed me out of the room given my fertility goals.

I found one study on adding HCG w/ Tcyp to maintain testicular function so maybe I’ll try to get my endo to read that.

Is there any sense in continuing down the HCG path but switching up the protocol to do smaller, daily injections or am I just chasing something that isn’t going to help.

Regarding the salt, we primarily eat sea salt. I’ll do the temp tests and read the sticky you mentioned tonight.

[quote]KSman wrote:
too much hCG and T levels still low

hCG mono is not going to work for you

hCG causing high T–>E2 conversion rates inside testes and anastrozole CANNOT reduce that!

Your higher hCG dose making things worse.

Your TSH is getting high, better close to 1.0
Have you always used iodized salt? [or deficient]
Check your oral body temperature when you first wake up AND in mid-afternoon [BOTH]

  • read the thyroid basics sticky

Labs:
prolactin
TSH
fT3
fT4 [please not T3, T4]

You have secondary hypogonadism and testes are not responding well to hCG.

You may need:
100mg/week T cyp/eth injected twice a week
1.0mg anastrozole per week. 1/2mg at time if injection
250iu hCG SC EOD to maintain testes and fertility
[/quote]


#4

If you take T + 250iu hCG EOD, your testes will be preserved. Most of your T will be from the injections. Your testes also a significant producer of pregnenolone, the mother hormone for all of the steroid hormone cascade.

hCG has the same effects on the testes with or without T injections. If hCG works, LH/FSH still --> zero.

Iodized salt contains iodine, sea salt does not!
There use to be iodine in bread, gone.
There used to be more iodine in milk from iodine teat wash in dairy barns.
You need iodized salt. Many gave had their body temperatures and vitality fail when they stopped using iodized salt.

Your whole household is at risk of iodine deficiency. Check temperatures of family.

Anyone feeling cold easily?


#5

Interesting on the salt and something I never thought of. Yes, my wife is always cold, although I think she has Raynauds - but maybe an iodine deficiency is also at play.

I’ll bring up adding T with my endo and share the studies with him, maybe freeze some sperm just in case to please the reproductive endo we’re seeing.

[quote]KSman wrote:
If you take T + 250iu hCG EOD, your testes will be preserved. Most of your T will be from the injections. Your testes also a significant producer of pregnenolone, the mother hormone for all of the steroid hormone cascade.

hCG has the same effects on the testes with or without T injections. If hCG works, LH/FSH still --> zero.

Iodized salt contains iodine, sea salt does not!
There use to be iodine in bread, gone.
There used to be more iodine in milk from iodine teat wash in dairy barns.
You need iodized salt. Many gave had their body temperatures and vitality fail when they stopped using iodized salt.

Your whole household is at risk of iodine deficiency. Check temperatures of family.

Anyone feeling cold easily?

[/quote]


#6

https://www.google.com/search?q=Raynauds&ie=utf-8&oe=utf-8#q=raynaud's+iodine+deficiency

Because low thyroid function undermines ones metabolic rate, it can easily contribute/potentate to the severity of other conditions.


#7

Just to support what KSman is saying about iodine… I tracked body temps for a couple weeks and was never above 96. Never did consume much salt in the first place, and for the past 5 years used sea salt exclusively. Other than the low body temp I didn’t have any glaring symptoms.

I purchased a strong iodine supplement and had 3 drops the first day… body temp shot up to 99.2 and I couldn’t sleep that night. The next day things stabilized and unless I’m sick body temp is right where it should be pretty much 24/7.

I also supplement with selenium monomethionine. It is a good idea to make sure you are getting enough selenium… if you have any autoimmune thyroid stuff going on iodine will make it much worse, if low in selenium. To my understanding iodine/selenium fall into the categories of minerals that not only need to be high enough, but need to be in balance in relation to each other.


#8

Why not keep HCG at 400, get E2 down and retest? 545 isn’t a bad result.


#9

[quote]KSman wrote:

hCG causing high T–>E2 conversion rates inside testes and anastrozole CANNOT reduce that!

[/quote]

KSman, do you know where I could find some more information on this topic? I’ve searched around but can’t come up with anything.

I’ve also seen cases where people were successful (usually too successful) at bringing E2 down with Anastrozole while on hCG mono. Any reason why that it may work for some and not others?