T Nation

HCG Necessary? Latest Bloodwork

Hi guys.

I’m about one year into TRT, and wanted to give an update. I’ve had some ups and downs, but overall very happy I made the decision to go down this road. I’m up about 20lbs, most of it muscle, but the biggest difference has been the improvement mentally and emotionally. I’m feeling like my old self again- confidence, decision making, overall enjoyment in life is where it used to be, and should be. We’ve taken my SHBG from 96 nmol/L to 29 nmol/L, and I certainly feel the difference.

That being said, I have had some slight issues with hcg. I’ve bounced back and forth between taking, and not taking my prescribed 500iu 2x weekly. When I do introduce it to my routine, I seem to retain water, am more lethargic, develop anxiety, and I can feel my estrogen rise. When I add the hcg, I develop the need for Anastrozole, which seems to eventually crash my estrogen (as you can see on this updated blood work)

Initial Bloodwork before TRT:
Total T: 927 ng/dL
Free T: 13 pg/mL
SHBG: 96 nmol/L
Estrogen: 14.5 pg/mL

Second Bloodwork before committing to TRT:
Total T: 767
Free T: 10
SHBG: Left off of this round, but can assume it was around the same as previous, or higher
Estrogen: 18.2

My current prescription is:
200mg Test cyp 1x week
1mg Anastrozole 2x week
500iu hcg 2x week

After many tweaks and experiments, I’ve found that the absolute BEST I feel, is when I do around 80-90mg test cyp 2x week, and nothing else. I pin myself 2x week in the shoulder with 28g needles- super easy and convenient. My estrogen has seemed to hold steady (I had puffy nipples through puberty, and the puffiness returns quickly when my e does get high). Energy is great, no anxiety, and no lethargy. I know many of you recommend testosterone only, with multiple injections a week as this is the most natural mimic of the body’s own production. My biggest question is, at 29 years old will I be okay going long periods of time without HCG? My doctor seems to think I shouldn’t go more than 10 weeks or so without it. Kids are not even close to being in the forecast right now, but I know in the next 5 years or so they will be. Will it be more difficult to fire up that LH signal later on if I don’t maintain it consistently with HCG?

As always, thank you all for the feedback!

I should also add that without HCG and Anastrozole I feel more lean & vascular, stronger, and have less joint pain. I had concern that my boys might shrink without it, and they did at first, but after a couple weeks seem to have returned to normal size.

Am I stating the obvious in saying… just don’t take the HCG and AI, or, at the very least, drastically reduce the AI dose? 2mg a week is a pretty decent dose.

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No not usually, a short regime of clomid will get things going again. Your AI dose is too high considering men have been diagnosed with osteoporosis at 3mg per week. A lot of doctors are unaware of the dangers of AI’s.

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Yeah, 2mg a week is pretty agressive. I’d just drop it and see how irgoes. You can always add it back in. Are they 1mg capsules? Give it a few weeks and just see.

Most guys that were fertile before starting trt hove no issues getting fertile again later on. I suspect a lot of guys that struggle had prior undiagnosed issues, but that’s just speculation.

Quite a few guys on the forum here have added hcg back in when they wanted kids, then stopped again once their girl was pregnant. Dextermorgan has a recent thread about getting a girl pregnant while on a full steroid cycle and having been on trt from a few years prior, no hcg, but everyone is different.

If you don’t feel as good running hcg (not uncommon) I’d not run it until you’re ready for kids. But bare internet advice :slight_smile:

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Appreciate the feedback! I also left out an important piece regarding the Anastrozole- I did not go with the 2mg prescribed dose initially. The consensus here was that it was way too high.

I started with .5mg week, and have experimented with different dosages ranging from .5-1.5mg. Recently I did go up to 2mg after a long stint of hcg because I could feel the E getting high.

I’d love to just drop both as long as it’s safe, and do things the “natural” way.

I was in your shoes when I started. I just take T now, every once in a while I’ll take 500iu H to see if I feel anything and usually don’t, or it’s minor. Doubt you’ll have any issues on T only, and you already know you feel better on that

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I agree, just take T and forget about estrogen for a while. People have a tendency to blame everything bad on it and it’s very rarely justified

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Where precisely did you find a doctor willing to give trt to someone who very clearly didn’t need trt?

Guys, when I drink whiskey, I crave hookers, meth and other peoples property, and always end feeling like shit. I feel best when I only drink beer, but when I play around with brown liquor I get crazy. So how should I go about this?

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Switch to tequila, clearly :joy:

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Vodka is the answer

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:joy:touché. Maybe I’m overthinking it.

Just wanted to be sure long term T without HCG wasn’t going to cause more problems in the long run.

I actually had multiple doctor consultations. Most were hopeful I could lower SHBG naturally, but after 6 months or so advised TRT. SHBG was close to 100 and free T was nearing single digits. Situation wasn’t improving and the ultimate decision was to get better now and enjoy my best years, rather than delay the inevitable and feel like a 60 year old man in my late 20s.

Very tough decision but glad I ended up moving forward with TRT.

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Forget about lowering shbg IMO. Just worry about getting free T where it needs to be.

I only figured out you were joking when I got to “other peoples property.” Before that I guess I was thinking that sounds reasonable. Ha

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That’s a tough spot, no question. I suppose if you’re feeling better that’s all that matters. But having SHBG that high with no explanation would keep me up at night. Hyperthyroidism would be where I’d put my money, but I’m assuming an even halfway competent doctor checked levels multiple times.

Yes.

I know some who, after being on TRT for one to as many as three years, conceived within two months of taking hCG.

Does not matter, hCG does not stimulate LH or FSH.

More importantly:

Testosterone >1500 good
Free testosterone 38.8 good
SHBG 29.2 good
Estradiol <5.0 not good, really not good

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Holy fuck, those testes were killing it naturally.

They really were man. I was as dialed in as could be as far as test optimization goes…diet, lifting structure, sleep, avoiding plastics, chemicals & blue light, etc.

I pretty much tapped myself out at total test in the 900s and the problem that came into play was that anytime I dipped lower than that, my free T was in the single digits due to SHBG levels. My doc also seemed to think the reason my body cranked out test at that high of a level to begin with was to overcome SHBG.

Not really worried about SHBG levels now as @highpull mentioned, just worried about keeping that T at 1200 minimum in order to have optimal free T levels.