T Nation

Personal Experience with HCG Induced Leydig Cell Desensitization

I am a 51 years old man that would like share my personal experience with TRT and hCG.
I will make a complete post later that describes my journey from 2009 until today including detailed bloodwork. Bloodwork in Norway is dirt cheap, like 20 bucks and the result are ready the next day.
That’s a long story including long term Novedex XT (Caspari Nutrition) and Arimidex usage (years).
No doubt in my mind that suppressed E2 for years caused a lot of floaters in both my eyes.
I have used Maca, Horney Goat Weed, Icadiin, l-Arginine, Cialis (2,5 mg ed) etc. etc. for years.
It started back in 2009 with low sex drive, sluggish erections and low energy.
Bloodwork showed test at 620 ng/dL and a little high estradiol, 0.20 nmol/L (0.06 – 0.18). My journey started, back to that later…
The Novedex XT boosted my testosterone to 1100 ng/dL in four weeks.
I dropped the dose from two capsules a day to 1 capsule eod.
The Novedex gave me energy, drive libido and sometimes raging anger…
I continued this from summer 2010 until the product was banned in 2015.

So, when I stopped the Novedex XT my testosterone dropped to 360 ng/dL, so I panicked…
Went to my andrologist, and he suggested a Clomid cycle, but we agreed that I should try arimidex, 1 mg a day. Got bad insomnia and extreme libido after one week, dropped the dose to ½ mg eod.
Continued this regimen until April 2017. Got some joint pain, but dropping the dose to e3d fixed that, Life was great! High libido, energy drive and motivation.

So, in December 2016 my body had stopped responding to Arimidex as it used to, my testosterone was low again, 340 ng/dL Drive, motivation, energy and mood was down. My LH was 7, so maby it was due to lack of vitamins.
One year earlier my LH was 6 and testosterone 580, and I felt great.

Did a lot of traveling in the US (Seattle, San Francisco, New York, Washington DC and Philadelphia) in the beginning of 2017. And to get more testosterone I upped my Arimidex dose, even when my estradiol was only 0.11 nmol/L (0.06 – 0.18).
It worked, extreme libido, mood lifted and I had much more drive.
But the joint pain and itchy dry skin bothered me a lot.

So, in April 2017 it was back to my andrologist.
He again suggested a Clomid cycle but we agreed that I should try Testogel.
I had no idea what I was about to do to my body…
Started with 50 mg testogel ed in April 2017.
WOW, it was magic! Mood, energy, drive, motivation and libido trough the roof!
But two months later, in june 2017 my testicles started to hurt 24/7 and they shrunk fast! The pain was really bothering me, And they pulled up thigh which made it even more uncomfortable.
So, back to my andrologist, and he gave me a prescription for hCG, and in the middle of june 2017 I took my first hCG shot of 500IU. My regimen was 500IU EOD for 1 week (4 shots) then 3 weeks off. It worked wonders with my balls, mood and sex drive, but I was still dependent of 2.5 mg Cialis ed. I addition I took 0.25 – 0.5 arimidex e3d.
Life was great, the hazzle with applying testogel every morning didn’t bother me at The additional 500IU of hCG eod every fourth week (2000 IU total) did wonders.

Then the horror show started!
In November 2017 I traveled with a couple of friends way up north to help them out at their cabin (150 k miles from home, no electricity, no water, no cellular coverage).
I had just taken my last of the four shots of hCG for the month, in fact it was the same morning as I travelled. Well, I remembered to bring Testogel but forgot the Arimidex.
So, one week later I was back home and was bloated, moody, jealous, low sex drive etc. I upped my dose of arimidex to 0.5 mg eod for one week.
I lost 5 pounds of water and was feeling much better one week later.
Then, on the 10th of December at 2 am I woke up and couldn’t fall back asleep, no matter what. My resting heart rate was elevated from 54 bpm to 65 bpm, something was wrong. My body tried to tell me something.
Three days later with almost no sleep I started to panic and went to back to my andrologist for a complete bloodwork (Friday 15th of December). Thinking I still had high estradiol I upped my arimidex dose to 1 mg a day. Well, on the following Monday I experienced anxiety for the first time in my life, and it was horrible, it was like having a large angry animal inside with sharp claws trying to get out.
I was extremely restless, couldn’t sit down even for 5 minutes.
The bloodwork showed normal test 720 ng/dL, and undetectable estradiol, SHIT!
It also showed elevated hematocrit of 55%, and elevated hemoglobin.
I stopped the arimidex but it was too late. I lost 12 punds the next week, extremely dry and itchy skin, looked good though, ripped, sixpack and everything, but I was a complete wreck.
Couldn’t work, had no sex drive, ed, no sleep, in other words I was non functional.
I gave two blood donations (medical) in two weeks, but didn’t feel any better.
Only difference was that my resting pulse dropped, and I couldn’t feel the heart beats anymore lying down.
So, I did a lot of reading and learned a lot about TRT.
I took my hCG one week early to get my estradiol level up again, but I reduced the dose from 500IU eod to 400 IU eod for one week.
NOTHING happened, one week later my testicles started to hurt again, and they felt smaller.
I panicked and started hCG again one week later but reduced the dose once more to 300 IU eod, and reduced the number of shots from four to three.
Still NOTHING, testicle atrophy and pain just continued.
Oh my god, I have fried my testicles, I have ruined my body.
I have desensitized my leydig cells by too much hCG, I’m fucked!
I went into a deep dark hole, the depression, anxiety and hopelessness was extreme!
I wanted to jump off the TRT train, I wanted to get out.

Went back to my andrologist and got a protocol for restart.
I asked him about hcg induced leydig cell desensitization and his answer was, relax, it’s temporary.
He gave me the following regimen:
Four shots of 500 IU hCG e3d for two weeks (four shots).
50 mg Clomid ed for 4 weeks, then 25 mg for three weeks, then 12,5 mg ed for three weeks.
I took the hCG as prescribed together with my usual testogel dose.
One week after the last hCG shot I applied testogel for the last time (Sunday 28th of January 2018). Well, the hCG had absolutely NO EFFECT, I could have used salt water instead.
I knew I was fucked, I would never produce my own testosterone again, my leyding cells was fried by too much hCG. I just wanted to end it all…
My balls had athropied to 50% of their original size and was hurting 24/7, it was uncomfortable to drive car and sit down.
On Tuesday (to days with no testogel) I was a complete wreck, the testosterone withdrawal symptoms combined with extreme depression and anxiety was almost too much for me. I became suicidal. I have never ever experience more extreme fatigue!
I am a 51 year old man with fried testicles and a suppressed HPTA, a restart was useless, but my andrologist was very positive so I continued. The next day was worse, I had to stay home all day.
On Thursday (four days later) I started to feel a little better.
On Friday I woke up at 4 am with a painful rock hard erection.
I stopped the Cialis three weeks ago, WTF? What is happening???
On Saturday I was myself again, no anxiety, no depression, tons of energy and drive.
Made passionate love with my fantastic and supporting wife.
All I take now is 50 mg Clomid ED, and it has been 6 days since I stopped applying testogel and stated the Clomid.
The most fantastic thing of all, my testicles are coming back, they are larger now than one week ago. So from this very recent experience (I have no idea where I will be in 2 weeks or 2 months). But so far I can say that the hCG definitely stopped working, but it seems it had no effect on the body’s own LH signaling hormone.
I feel fantastic now, and will drop the Clomid dose to 25 mg ed tomorrow because I’m afraid to over stimulate my HPTA and testicles.
I will contact my andrologist tomorrow to get his view on the reason I’m back only after 6 days.

Thanks for sharing. Keep us updated.

so what would you have done differently? as far as I’ve read, you never took excessive amounts of HCG… why do you think a possible leydig cell desensitization happened?

most of the members here take the same dosage of HCG (or a slightly smaller one) as you but not just 1 week on/3 weeks of, but permanently.

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hCG can be damaged if supplied wet. Should be mixed by you. You can use a home pregnancy test and should be positive with 250iu subq EOD. If not positive the hCG is not good.

What were LH/FSH prior to any treatments? You may have been on progressive secondary.

High dose clomid can induce high E2 levels from high T–>E2 inside the testes and anastrozole cannot manage that inside the testes. High dose clomid can create high LH/FSH and high LH can affect the LH receptors just like hCG. 250iu hCG subq EOD is often sufficient. 50mg clomid is a bad dose in almost all cases.

When on clomid, labs should be TT, FT, E2 and LH/FSH. You need to see what LH/FSH levels are to know what you are doing. You can also gain some understanding by reading the HPTA restart sticky.

As for some things your doctor has been doing: Most doctors are very useless at TRT and have shallow understanding and dangerous practices.

I have to question why you are OK injecting hCG but are not injecting T. T is 100% absorbed and least cost. You can inject T subq twice a week with #29 1/2" 0.5ml insulin syringes and dose anastrozole at time of T injections.

More info you need 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.


regarding the verification of the HCG with a pregnancy test - how do you do that? do you just drop a few units of HCG on the stick or do you have to pee on the stick yourself after injecting HCG for a while?

You would drop the hcg onto the pregnancy test “stick”.

Follow directions on the package, morning stream of urine should be positive. Testing the hCG directly might be positive even if the product is damages or thinned out.

Update and need advice.
I have lost 20 pounds since the TRT nightmare suddenly started back in December 2017.

For the first 10 days on Clomid only (50 mg ed) I felt OK after the initial crash in the beginning.
Bloodwork after one week (10 days) on Clomid, I felt OK but had no sex drive and felt drained in the evenings.
Test taken: 09th Feb. 2018
Testosterone: 145 ng/dL (ough)
Estradiol: Not detectable
SHBG: 73 nmol/L (8 - 60) (ough)
FSH: 10 U/L (1 - 12)
LH: 5 U/L (1 - 10)
Free test index: 0.7 (2.3 - 9.9) Oh shit!

My SHBG was 35 nmol/L before I started with Clomid, and 73 after 10 days on Clomid???
How is this explained? My liver is, or at least was in good working order…

This was bad news, so I scheduled a new blood test one week later, and now I was a wreck.
No energy, depressed, tinnitus, insomnia, ed, no sex drive. Thank God I have a supporting wife!
Test taken: 16th Feb. 2018
S-TSH: 1.2 U/L (0,20 - 4,0)
S-Free T4: 17.1 pmol/L (11,0 - 23,0)
S-Free T3: 4.5 pmol/L (3,5 - 6,5)
Testosterone: 290 ng/dL (still LOW)
Estradiol: 0.08 nmol/L (<0,18)
SHBG: 79 nmol/L (8 - 60) (ough)
FSH: 11 U/L (1 - 12)
LH: 8 U/L (1 - 10)
Free test index: 1.3 (2.3 - 9.9) Oh shit!

So my HPTA is really back online, but my testicles are not, at least not yet.
This last blood test was taken on the 16th of February 2018, and I felt like a 90 year old man getting to the doctors office. I took a new blood test today, and will get the results back this evening. What really concerns me is the extremely high SHBG, and that my andrologist is not commenting on it!

I’m not feeling well at all, I know it’s only been three weeks since I started, but I barely exist.
Can’t work, almost no sleep, no work out, depressed, lethargic, extremely dry and itchy skin, no libido at all.

So, in a desperate attempt to be able to exist during this restart experiment I contacted my andrologist again, and in addition contacted the hospital with the very best endocrinologist. But there are several weeks waiting time since my situation is not life threatening.

My andrologist told me I could take 1/2 a pack with Testogel eod, while on the Clomid regimen that would not suppress my HTPA because my test levels are so low. He did not answer my questions about my sudden high SHBG.

My Clomid dose is now reduced to 25 mg eod.

Well, I feel a little better with a little testogel applied, but I’m careful not to suppress my HPTA, so my test levels are still low combined with extreme SHBG.
I’m waiting for the blood test result I took this morning, and will post them as soon as they are in.

I also tried another thing in a desperate attempt to feel better, but it hasn’t had any affect yet. My E2 is low, and I have dry and itchy skin. So two days ago I took one of my wifes E2 patches (Estradot 50 micro grams), cut it half and applied it to my stomach. It’s a four day patch, but maybe half a patch isn’t enough? My skin are still dry as a desert… and I don’t retain water at all.

So my question to you is:

  • Should I just quit this experiment and start TRT, are my testicles desensitized from too much HCG (500 IU eod for one week every month for 6 months)? Will they ever come back? I have read that some guys using extreme hCG dosages for months got their testicles back using clomid and novladex, is that a fact? I can get my hands on a pack (100 pcs) of 20 mg Nolvadex tomorrow.

  • Any theories why my SHBG has skyrocketed? Do I have some strange reaction to Clomid?

Thank you so much for taking the time to read this, I have edited my initial post with correct blood values and more detailed information, and tried to remove as many typos as I found…

As it stands now testes are’t functioning do to desensitization, clomid raises LH and SHBG. You went into all of this with blindfolds on. 50mg clomid everyday is insane. Clomid raised your SHBG binding up all your free T, now affecting your E2 levels.

You’re over 50 years old and you’re expected to be low T at this age, TRT is long overdo. It’s time to quit screwing around and wasting your life chasing your natural production after the age of 50. Successful restarts at 50+, insanity.

Thank you for you quick and honest reply.
Seems my andrologist has no clue!

The only reason I wanted to stop TRT was the bad experience with anxiety and insomnia after 6 months in heaven. Combined with testicle pain and atrophy.
I have no issues doing TRT as long as I can function as a normal human being, I hope I never will experience that extreme anxiety again. But it can maybe be explained by low E2.
The strange thing is, I have had low E2 before by too much Arimidex, but that only gave me high libido, joint paint dry skin and insomnia. Stopping Arimidex for one week cleared everything up.
I have never experienced anxiety from low E2…?

You need 50mg twice weekly and hold off on the AI, I had no issues at all with E2 levels at this dosage, can you imagine how my experience would have mirrored your own if my doctor had placed me on an AI?

You need to test cortisol levels before and after starting TRT, high/low cortisol levels can make things worse emotionally.

I had minor testicle pain that eventually subsided and the atrophy ceased after going from 75mg once weekly to 50mg twice weekly. My testes always pull up tight when E2 is high, my testes are my E2 gauge on the higher end.

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Thank you.
So you advice is, stop screwing around and start TRT the proper way with two shots pr. week?
Then weekly blood work in the beginning and get a complete hormone panel including cortisol, prolactin, progesterone, DHEA etc?

Another question. Will my extremely high SHBG come down after I stop the Clomid?

Don’t see why it wouldn’t given time, never seen a case where it didn’t come back down. Your HPTA isn’t responding well to Clomid, the only thing that Clomid is doing well is raising SHBG.

TRT time.

Last question today.
Here in Norway the standard regimen is one shot of 1000 mg Nibedo (Undecanoate in the US) every 90 days.
That will give me a testosterone level of a 95 year old.
The Testogel worked perfectly until I crashed, and I don’t want to experience that again!

I would like to be a little careful in the beginning, and I read that a good starting dose is 50 mg twice a week.
What type of test are the best for TRT, slow acting Cypionate, Enanthate or the short acting Propionate?

Do I need to take other hormones as well?

I’m really afraid that I never will experience a good night sleep ever again…
That disappeared on the 10th of December 2017…

Nebido doesn’t workout well for everyone as it becomes difficult to keep levels stable throughout the 90 days, Cypionate works well for everyone and has a slightly longer half life than Enanthate. The only difference between Cypionate and Enanthate is the half life difference, which is why it’s easier to get Enanthate outside the USA. It’s cheaper.

Sustanon is better than Nebido and can be injected once weekly or twice weekly.

I’m on Cypionate 12.5mg EOD (50mg weekly), no other hormones. 17.5mg EOD produced to much E2 for me to handle, will find out where everything is in 5 weeks.

I seem to be sensitive to androgens.

Blood work from this morning just came in.
Test taken: 23th Feb. 2018
S-TSH: 0.93 U/L (0,20 - 4,0)
S-Free T4: 20.0 pmol/L (11,0 - 23,0)
S-Free T3: 5.1 pmol/L (3,5 - 6,5)
Testosterone: 470 ng/dL (going up)
Estradiol: 0.12 nmol/L (<0,18) (patch is working)
SHBG: 61 nmol/L (8 - 60) (really coming down)
FSH: 12 U/L (1 - 12)
LH: 11 U/L (1 - 10)
Free test index: 2.7 (2.3 - 9.9)

Well, LH and FSH are on the top of the reference range, but that will not stick.
My testicles are responding, but not as good as before I started hCG in june 2017.
Seems that I need to jump on the TRT train in the near future, but I will do a lot more reading first…

My testicles are still aching (dull ache), mostly while sitting down.

Hi. Thank you for your answer and sorry for my late reply!
I have been REALLY down for the last couple of weeks.
I had no clue what I was doing regarding testogel and hCG.
I will take you advice seriously, read and learn as much as I can to get my life back on track.
I think I was dreaming a little too much thinking I could restart successfully.

My latest blood test was not all that bad, but of course, my raised LH and FSH will not stick.
And I also know that there is no way to add testosterone without suppressing the HPTA.

Thank you again.

Thanks. Seems that I need to find a good TRT doctor.
And, they are non existing in Norway, as far as I know.


So, it seems that I have desensitizied my testicles from 500 IU HCG EOD four times (mon, wed, fri, sun) every forth week for 6 months, 24 injections total.

But they are still making T, but not as before.
Before HCG, a LH of 7 gave me Test serum levels of 400 ng/DL, and a LH of 8 gave me Test serum levels of 520 ng/DL
Now, a LH of 10 gives serum Test levels of 450 ng/DL.
Before that high LH would at least give me serum levels in the 800 range.

Because of all the benefits of HCG, I would still like to use it when I start TRT, but I must avoid to desensitize my testicles even more.
Is that possible, or am I fucked? Will low dose HCG have any effect at all?
I have read a couple of stories of guys restoring some of the LH response by a several month pause, then 4 weeks with clomid and nolva. Is that just bull?