T Nation

HCG Monotherapy Protocol

Seems like a wide range of hcg monotherapy protocol. Found one study on it and they used 1500 iu hcg 3 times a week and had long term follow up. Thoughts? See study:

Back to 2014 Annual Meeting Abstracts

Human Chorionic Gonadotropin is Effective as Monotherapy for Men With Symptomatic Testosterone Deficiency (Hypogonadism)
Ravi Kacker, MD , Mark Abair, BS, Kenneth C. Byl, BS, William Conners, III, MD, Abraham Morgentaler, MD.
Men’s Health Boston, Brookline, MA, USA.

BACKGROUND: Administration of human chornionic gonadotropin (hCG) is an FDA approved treatment for hypogonadotrophic hypogonadism. hCG stimulates the testicles to produce testosterone and unlike testosterone therapy, preserves fertility and testicular volume. We present our experience with hCG monotherapy for symptomatic testosterone deficiency at an outpatient andrology clinic.
METHODS: An institutional review board approved retrospective chart review identified 42 men who started on hCG monotherapy for symptomatic testosterone deficiency at Men’s Health Boston (Brookline, MA). All men had a total T <350ng/dL or free T <1.5ng/dl, received instruction with a nurse educator on drug preparation and self-injection, and were seen in follow-up. Starting dose was 1500IU three times a week and adjusted based on symptomatic response and lab results.
RESULTS: Mean age was 39.6y (range 20 - 62 years) and mean follow-up was 12.9 months (range 1.5-49 months). The primary reason for pursuing hCG therapy was to maintain fertility for 34(80.9%) men and to preserve testicular volume and function for 8(19.1%) men. 24 men (50.7%) were on clomiphene citrate or T prior to switching to hCG therapy. hCG therapy resulted in a satisfactory biochemical and symptomatic response in 40 men (95.2%). Mean total T levels increased by 709 ± 303.9 ng/dL (p <0.001) and mean free T levels increased by 2.02 ± 0.87 ng/dL (p<0.0001). Successful treatment was noted over a broad range of baseline LH levels, ranging from 0.9-14.3 IU/ml, mean 3.9 IU/ml. 27 men (64.3%) continued on 1500IU three times weekly for the duration of therapy, 8 men (19%) had their dose increased and 7 men (16.7%) had their dose decreased. Two men (4.8%) discontinued hCG due to lack of efficacy and 7 men (16.7%) discontinued hCG in favor of T when infertility no longer was an issue. 6 (14.2%) men developed nipple sensitivity or breast swelling, which resolved in 5 men after reducing the dose or with the addition of an aromatase inhibitor or SERM. 2 men (4.8%) developed hematocrit over 54, one of whom continued hCG at a lower dose.
CONCLUSIONS: hCG is an effective and durable treatment modality for men with testosterone deficiency, even in men with LH levels in the high-normal range. Advantages over standard testosterone therapy include preservation of fertility and testicular volume. The primary limitation of this treatment is inconvenience, as it requires subcutaneous injections three times weekly.

3 х 1500ui is a fertility protocol, not for optimizing t. This is incredibly high dose. If you want to feel better you never want too much HCG.
I would suggest to start with 100ui daily.

@vonko1988
Read the title. HCG Monotherapy means therapy only using HCG. 100iu/day of HCG only would not be enough to bring levels up high enough. HCG monotherapy hasn’t shown great results in itself but doing very small doses would be extra horrible.

Should I say f it and stay on test?

Literally everyone I’ve ever seen on here doing HCG monotherapy eventually switched to TRT and they don’t switch back. Even people using testosterone with HCG have issues.

I know people for who 100ui per day is enough for mono

I know people with 100 total T levels that live a normal life. Doesn’t make me want to do it.

hCG mono worked well for me, equally well than TRT. Did 350 IU eod which raised T to 550 ng/dL and freeT to 12 ng/dL.

1500 IU twice or thrice per week is too much, that’s a dose used to reverse leydig cell atrophy and induce spermiogenesis.

Look at this study here

They were prescribed an average of 2000 IU hCG weekly split into multiple injections.

Depends how much is your natural production. If you had midrange testosterone levels before 100 ui per day can put them in the high normal range. Depends how responsive your testicles are to the HCG stimulus. A few great docs recommend it as a starting protocol for HCG mono.

It put @johann77 at 500 total T and 12 free T. There aren’t many that would be fine with those levels unless they’ve been at 200 total T for a long time and never experienced anything above 500 & 12. How many times have you seen someone get on TRT, come back with those levels and say “I’m finally there”. None.

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Agree, but if you are on 500 initially there is a good change 100ui daily takes you to 800-900 which can be enough for some people

The average T conc of men my age (42) is around 500 ng/dl with a free T of 11 ng/dl. Ergo 50% of men my age have T levels lower than this. So your conclusion would be that all of these men (how many hundred millions alone in the US and EU?) are not ‘there’? And all of them should go on TRT to increase their levels to above 1000 ng/dl to get ‘there’?
The essence of testosterone replacement therapy is to restore T levels of hypogonadal men to levels of ‘normal’ men. Its not to optimize whatever.

Thats the recommendation of every medical society and every guidline, also those in which Morgentaler is part of.

Even here on this forum filled with bro science nonsense a big portion of men state that their weekly dose is below 100 mg, and even more man on EM report weekly dosages of below 100 mg.

You are continuing to state this all over again citing the crappy endocrinoly society guidelines, but the practice is many many men need much more to feel better. Im just one example, I had 560 before TRT. @dextermorgan had 600. I will find you 10 more in 10 minutes If needed. TRT is not about numbers and we certainly do not understand all the reasons why many men need higher t levels to feel normal.

My buddy here who started TRT had 200s before TRT and he did not feel good before 1000. Even at 600-700 he felt crappy. Just one example, but the forums are full of such

Hey buddy,

I´m on HCG Monotherapy. But I’ve had a testicular shrinkage / leydig cell atrophy . I currently need about 800 I.U. hcg every other day to get to 450 ng/dl. I’m satisfied with that, no symptoms. I only do this to have kids. Then I’ll go back to TRT.

Best Regards
I have a thread here: Hypogonadotrophic Hypergonadism/HCG/Fertility

If they didn’t at least test out levels higher than 500 I wouldn’t have any respect for them at all. Who wants to be bottom average by choice? Their genetics screwed them with below average T levels and they have the ability to have any level in that range they want but they choose one tick higher than they were? We are just on two different planets and I can’t understand why someone who is 4ft tall and given a magical elixir capable of making them grow to any height on the male spectrum would choose to be 5’7 if they could be 6’1.

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Just show a little more ability for self-reflection, and take into account your lacking education in medicine or a related field.

Because short people live longer.

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George Louis Costanza :slight_smile:

Ive had enough dealings with endocrinologists and their guidelines, rejecting me any kind of therapy for a long time because Im in range, and hundreds of other patients around the world. Luckily I have the financial option to consult knowledgeable doctors from over the ocean and start TRT, but many other do not and suffer. You can see the same threads on all forums all over again every day - the guy has the symptoms but he is refused treatment because he is in range.

So I have ZERO respect for the guild of endocrinology. They are the worst kinds of doctors doing more harm than good.