T Nation

New Dr, New Meds


I’ve been on T replacement for approximately 2 years now. My previous urologist would only prescribe testosterone. When I complained about testicular pain and shrinkage, he said I could either continue with the T or not. I recently found a urologist who is much more open minded. She continued with the 200mg/wk of T and added in HCG and Tamoxifen.

My concern is the Tamoxifen. I’ve heard of some negative side effects and I question the necessity.

Does any one have experience with Tamoxifen, especially in combination with T and HCG?


Clomid is the ugly stepsister. Nolvadex/Tamoxifen is good.

Do not combine hCG and Tamoxifen. You can overload LH receptors.
One or the other.

The recipe is:
anastrozole to control T–>E2
hCG [or a SERM] to preserver the testes and/or fertility.


Did that get confused?

Most docs have no idea about LH receptor overload and effects.

Please follow these links in the 2nd post of the first forum topic:

  • advice for new guys - note the first paragraph
  • protocol for injections
  • finding a TRT doc

Please post labs, range and symptoms


Thank you for your response. I will not be taking the Tamoxifen then, as long as the prior authorization gets approved for the HCG. My most recent labs are from 12/16/15:

TT 479 ng/mL 250-1000
FT Not checked
E2 32 pg/mL </=39
Prolactin 7.1 ng/dL 2.0-18
DHT Not checked
LH .3 mIU/mL 1.5-9.3
FSH <.7 mIU/mL 1.6-8.0
PSA .8ng/mL 0.0-4.0

My symptoms now, on only the T are: low libido, weak erections, testicular pain and shrinkage.


Are you injecting only once a week?
When were labs done prior to last injection?

Please see those stickies.


I am injecting twice a week. Those are the most recent labs I have. I am due for labs, but, with the new urologist and new meds, she wants me to wait 6-8 weeks. I am still waiting on the prior authorization for the HCG.

I have read through the stickies, although it’s been a couple of years. I will read them again. Thank you.


You are injecting 100mg twice a week and have TT=479

LH/FSH should be near zero and do not need to be part of your TRT lab work.

You appear to be a testosterone hyper-metaboliser. We typically see guys like this needing 300mg to get where others are on 100mg. Half-life is similarity affected and EOD dosing is needed. When were the above labs done relative to prior injection?


It’s been awhile since I’ve posted. Looking back, I made an error in my first post. I am only injecting 100mg/week divided in to 2 shots IM.

I was never able to get my insurance company to cover HCG. They even sent me for a semen analysis that came back with a 0 sperm count. I tried the tamoxifen, but it made me anxious. Last month I found a reputable online pharmacy to get the HCG from for a good price. $60/month vs the $250/month CVS quoted me.

I have new blood work from December 29th. This is from on the day of my T injection, before injecting and prior to starting HCG.

Total T- 597 ng/dL 250-1100
Free T- 152.2 pg/mL 35-155
E2- 25 pg/mL </=29
E2 Free- .63 pg/mL </= .45
TSH- 1.73 mIU/L .40-4.50
Glucose- 92 mg/dl 65-99
Triglycerides- 201 mg/dl <150
Hematocrit- 44.4% 38.5-50.0

Since this test I have started HCG at 250iu EOD subQ. I wasn’t expecting any results from that yet, but I can at least feel a sense of having testicles again. I still struggle with sex drive, erection quality and just a general grumpiness. I’m hoping to get more blood work in about 4 weeks.


-age: 40
-height: 5’11 '
-waist: 34"
-weight: 190
-describe body and facial hair: Normal body hair and full beard
-describe where you carry fat and how changed: Mainly around my midsection, hasn’t changed
-health conditions, symptoms [history]: herniated disc
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Occaisional Tylenol or Advil
-lab results with ranges: See prior post
-describe diet [some create substantial damage with starvation diets]: Cereal, oatmeal, waffles , or pancakes for breakfast with 2 20oz coffees, Lunch is usually 2 yogurts and a fruit, Dinner is mostly junk. I work 2nd shift, 3pm-2am, and my wife is in college full time, so I usually eat out.
-describe training [some ruin there hormones by over training]: None
-testes ache, ever, with a fever?: Yes, no fever
-how have morning wood and nocturnal erections changed: Hit or miss