T Nation

HCG on TRT, Effectiveness and Potential Side Effects?

Hi all,

Got my blood work done a couple weeks ago found that I have low free and total T.

Age: 28
Height: 5’ 10
Weight: 165 lbs

Free T: 52.6 pg/mL
Total T: 355 ng/dL

Following this result I scheduled a couple appointments with an MD who runs a Hormone Replacement Clinic.

Monday I’ll get the results of a full blood work panel…interested to know my SHBG levels.

I’m committed to getting on TRT but I want to make sure I remain fertile.

When I speak with the doctor I’ll ask to be on HCG,TRT, and an AI. My question is related to the side effects of HCG.

How likely is HCG to induce gynocomastia? Also, will HCG reduce the positive effects of TRT on mood, sex drive etc…? Is the use of an AI more frequently able to keep gyno in check?

I’ve attached a great study on fertility for men previously on TRT or on TRT and HCG. The evidence is minimal but it seems to point to HCG maintaining fertility on TRT. I’m wondering if anyone has access to any other studies on this. I’m wondering what percentage of men maintain fertility? Especially those in my age group late 20s.


link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref58

hCG at 250iu subq EOD does not have negative effects in almost all cases. The effects of not using are shrinking testes and a scrotum that is pulled up tight. Some then also have a dull 24x7 ache in their testes. Many who have been on TRT without hCG, report a good improvement on mood when hCG is started. So we are aware of some effects independent of T level effects.

hCG simply provides LH receptor stimulation the same as LH.

Gyno is from estrogens, not hCG. Most men need an aromatase inhibitor [AI] to keep estradiol [E2] in a favorable level near E2=22pg/ml - 80 pmol/L.

When you post lab work, always include ranges.
We often pick up issues that doctors miss, try to post all of your labs.

Ask for:

  • self inject 50mg T cypionate twice a week, subq with #29 1/2" 0.5ml insulin syringes [Not 1.0ml !]
  • 0.5mg anastrozole at time of injections
  • 250iu hCG subq EOD

Many here have thyroid issues, often from not using iodized salt. See related below.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


Thank you for the thorough response.
I’ll post my blood work below. I only got free and total since I paid out of pocket at Sonora Quest but I’ll add the full panel results on Monday.

I’ll take your advice and get educated on Thyroid function as well.

Do you know how effective HCG while on TRT is for maintaining normal production of sperm?


Free Testosterone and total Testosterone:

250iu hCG SC EOD was shown to produce about the same level of intratesticular testosterone [ITT] which indicates normal function as far as LH action goes. Guys here on T+hCG have made babies. So its up to your testes. Sperm count would be better with some FSH and one can switch from hCG to a SERM, Nolvadex[referred] or Clomid in preparation for conception. High ITT is needed to make sperm and ITT can be up to 80 times higher than serum T levels in natural guys. [High hCG or high SERM doses are harmful]

FT lab ranges can vary greatly from one lab company to another.


Thanks for the info here. Feeling optimistic that there are options to keep ITT levels high.

I’ll follow back with my lab work on Monday.