T Nation

HCG Monotherapy?

Hi All,

Here is my story. 23 years old (almost 24) and have suspected secondary hypogonadism. I did 2 steroid cycles in my early 20s. After the first, I got bloodwork done a few months after PCT, and discovered my T levels were in range but at the lower end. Had all the classic symptoms of low T. Didnâ??t investigate further because the doctor said my levels were fine. Started another cycle 3 months later and decided to not PCT after the 12 weeks I planned to be on. I stayed on for about 8 months and then did a PCT with HCG followed by a SERM.

Got bloodwork done about 4 months after PCT because I had low T symptoms again, and I was hoping to get my wife pregnant. T levels were even lower, and LH and FSH were also low. I decided to try a restart. Took 10,000 IU of HCG over a 3 week period starting at 2500 IU per shot tapered down to 500 IU per shot. Got my wife pregnant. So I decided to run Clomid after the HCG. I didnâ??t feel well on Clomid so decided to jump back on Testosterone @ 200mg/week and felt good.

Had an appointment with a Urologist and I told him my story. He advised to stop taking Testosterone for a month and go for bloodwork, if my levels were low I would get TRT. Went off for 5 weeks and got bloodwork done, here were the results:

Prolactin: 10 ug/L (Ref: 3-13)
LH: < 1 IU/L (Ref: 1-9)
FSH: < 1 IU/L (Ref: 1-19)
Estradiol: 47 pmol/L (Ref: 40-160)
Total T: 3.9 nmol/L (Ref: 6.1-27.1)
Free T: 111 pmol/L (Ref: 110-660)
Bioavailable T: 2.6 nmol/L (Ref: 2.8-15.5)
SHBG: 13 nmol/L (Ref: 13-89)
TSH: 2.35 mIU/L (Ref: 0.5-5)

I felt awful during this time. I have been fatigued, noticed very achy shoulders and stiffness upon waking, anxiety, heart palpitations/arrhythmia, and lost muscle + gained fat in midsection.

Surprisingly, I didn’t get the prescription for Testosterone. My Urologist wants to investigate a little further to find the cause of my low T (he obviously was not surprised by my results above since this was all to be expected with a hormone crash). He suspects I may have had low T even before I started using steroids (I have gyno that never went away from puberty). Looking back, I agree with him. I had all the same symptoms of low T before ever using steroids, and when I was on cycle, all those symptoms disappeared.

My Urologist is sending me for an MRI of my pituitary, and in the meantime if I wanted therapy, he offered either Clomid or HCG. So I opted for HCG therapy. My Urologist wanted to prescribe me 2500 IU injections 3x per week, but I thought that was a little excessive, so we agreed upon 1000 IU 3x per week. I have 4 months worth, and will be getting bloodwork done in June.

How worried should I be about my E2 levels spiking? Luckily my Urologist will prescribe Arimidex if needed, but only if my E2 levels appear elevated. Can I stay on a protocol like this longterm? Will my leydig cells desensitize over time at this dose?

The high prolactin would be inhibitory of LH/FSH and your history make the CT scan of your pituitary a great idea. There was a question posted recently about whether hCG would desensitize the leydig cells and your story is a great example of why this comes up in research studies. 2500 units might be ok for fertility doses when conception is difficult but I think this dose is confused with long-term therapy. I’ve seen most people taking 250iu-500iu EOD or E3D. I think I will start at 500 E3D and once my testes fill out I’ll see how 250iu’s performs.

You’re right my prolactin is a little on the high end. Back in November 2013 it was at 6 ug/L using a different lab (Ref: < 18 ug/L). So it seemed to have went up a bit. Could having sex the night before the morning bloodtest effect prolactin? Hopefully that’s all it is, but we’ll see how the MRI goes.

I guess I’ll continue to use 1000 IU 3x per week atleast until I restore testicular volume, and then get some bloodwork and see where I’m at. I think doctors like to prescribe higher doses because they want you to use up your 10,000 IU within a month (otherwise you’re wasting it).

Don’t go for HCG mono therapy. Been there done that. E2 is basically uncontrollable. Even now on standard TRT I reduced HCG to 2 250iu injections a month. E2 has been much more stable.

HCG mono worked pretty good for me. E2 was much easier to control than on a SERM. Might go back to it. I think the key is to find a dose that is just enough to do the job.

It seemed that for now, either HCG or Clomid were my options. I feel the best on Test, I feel a little better on HCG, and I feel no better on Clomid, so I chose HCG over Clomid.

My Urologist knows that I want on Test, but I guess he does not want to compromise my fertility since I’m not done having kids. I told him that HCG + Test together should maintain my fertility, but he doesn’t like to prescribe a “cocktail” of drugs as he called it. One at a time. We’ll see what my levels are at from HCG, and see what my MRI results will be.

Androxal is on the way anyway. If you’re secondary, or you just want optimal T levels, that’s going to be the wonder drug. It should be released this year. I’ll probably switch over and see where my levels are. More than likely I’ll go the Androxal route and top off with a little T cyp.

Anyone else think the FDA is out of control? Androxal should have been out years ago. This is nuts!

Please aware me on Androxal?