T Nation

Question About TRT and HCG


#1

I've been on TRT for six months with what seems to be a fairly standard protocol of 200mg test C/wk, 250iu HCG 2x/wk and .25 mg Adex EOD. This has been through a clinic that specializes in TRT.

I had my yearly physical with my regular Doc yesterday and discussed TRT with him. He is willing to take it on and prescribe the same levels of T and Adex but says that he doesn't think HCG is necessary.

Obviously, I can search some articles out that say the opposite and intend to do so - perhaps I can change his mind. There are a few great articles on the web by Crisler and others praising the effects of HCG.

But the real questions are, if I can't change his mind, am I killing my program by not using the HCG? Would I be better off staying with the clinic I am at, or even pursuing an alternative source for the HCG? The cost at the clinic is roughly 3x what it would be if I switch, so I need to consider it.

Thanks for your help.


#2

there is no way to know for sure.

There are some general guidelines but you haven't provided any details about your situation, your symptoms, your blood test results, your responses to medications which makes it impossible to even hazard a guess.

Does everyone on HRT need HCG? No.
Do some need HCG to support pregnenolone production? based on user input, seems like yes.
Do some need HCG to help maintain fertility or avoid testicular shrinkage? yes.

If you had sky high FSH/LH and low T (primary hypogonadism) then it is more likely (I believe) that HCG would not be as beneficial as someone who is secondary.

I could go into personally stories about being on and off of HCG, but the bottom line is that everyone reacts differently to this art we call HRT. The only way to know for sure is to do a trial run of stopping HCG injections and see how you do. If you crash or experience worsening symptoms, couldn't you take that 'evidence' back to your doctor to try and get him to change his mind?

at 200mg a week, I really really hope that you are monitoring your estradiol, TSH, and cortisol levels.


#3

Thanks for your answer. I realize the questions are pretty general and I didn't include all the blood work (which is at home but can post later).

As I expected, it's an individual thing where HCG is concerned and I certainly agree with your suggestion to discontinue use and monitor what happens.

As for monitoring my blood levels at 200mg, I am due for another draw in 10 days, so yes, I am paying attention. Frankly, I view the clinic as a sort of "cookie cutter" sort of place - I have talked to two other patients there and they were both started on exactly the same protocol as I was. As such, I think it is very important to monitor everything closely and obtain as much information as possible - which is why I am here.


#4

200/wk is double the "standard" starting dose, BTW. But, I imagine you feel pretty good on it :slight_smile:

As far as the hcg goes, as mentioned, no one can really answer that for you. Stop it for a couple of weeks and see how you feel. Personally, I feel MUCH better on it. Plus, my nuts don't looks like raisins.


#5

Apparently, I picked a liberal clinic and yes, I feel pretty good. It will be interesting to see what my upcoming blood work shows. Hope they haven't got me all out of whack.

Once I get the results back, I'll post both pre TRT and new bloodwork along with all the other info. If my numbers are in line, I will probably drop HCG for two weeks to see. I appreciate the help - we are all new at this once but I'm a fast learner!


#6

I am new so excuse me if this has been discussed already. On my lab tests I see a total T result, an SHGB result, an Estradiol result, and a Cortisol result, but no Free T result. However, there are Free T3 and Free T 4 results. Are these the Free T results that are being discussed in the various threads?


#7

SoftD - please start your own thread for your questions.

(Free T can be estimated by looking at Total T vs SHBG). Please post your tests results in your new thread so that we can review and comment.


#8

OK - Here is the original blood work.

CBC
White Blood Cell 6.5 3.9 - 11.1 K/ul
RBC 5.06 4.2 - 6.0 M/ul
HEMOGLOBIN 16.7 13.2 - 18.0 g/dl
HEMATOCRIT 51.0 38.5 - 54.0 %
MCV 101 H 80.0 - 100.0 fl
MCH 33.0 26.0 - 34.0 pg
MCHC 32.7 31.0 - 37.0 g/dl
RDW 15.2 11.0 - 15.5 %
PLATELET COUNT 214 140 - 400 k/ul
MPV 9.3 7.5 - 11.6 fl
DIFFERENTIAL
GR% 65.3 38 - 75 %
LY% 29.6 15 - 49 %
MO% 2.6 2.0 - 13.0 %
EO% 2.0 0 - 8 %
BA% 0.5 0 - 2 %
GR# 4.3 1.6 - 8.4 K/ul
LY# 1.9 1.0 - 3.6 K/ul
MO# 0.2 0.0 - 0.9 K/ul
EO# 0.1 0.0 - 0.6 K/ul
BA# 0.0 0.0 - 0.2 K/ul

TUMOR MARKERS
PSA, TOTAL 0.65 0.0 - 4.0 ng/ml

ENDOCRINE EVALUATION
TESTOSTERONE, TOTAL 270 L 280 - 1100 ng/dl
SEX HORMONE BIND GLOBULIN 18 10 - 80 nmol/L
TESTOSTERONE, FREE 10.50 1.6 - 22 ng/dl
-------------------------------- END OF REPORT --------------------------

As I've learned more about this, I realize that they really didn't check much in order to start TRT - pretty much that I have low T and off we go. Since this blood work in early Nov, they have also changed the way they charge such that the only thing they check at 10 weeks without an additional charge is total T. And now, if you need anything past Test such as HCG or Adex, they have effectively doubled the cost. Bottom line is that I think they are more interested in revenue than the patient and I am defeintely switching to my primary care doc next week.


#9

Good luck with your primary. Be prepared to explain things, even take some documentation with you. Also take copies of your previous bloodword (you did get copies didn't you?). Hopefully you'll come away with scrips for T and hcg. I've ran into snags getting a scrip for Adex, so I'm using the liquid at present.