T Nation

Restarting TRT/HCG: My Protocol

Hey everyone, if you have checked my past threads you will see that I was on TRT for 6 months but decided to stop in order to have my sperm frozen. I stopped TRT on March 1st 2020 and yesterday I managed to freeze a decent sperm sample ( 21M/ml ) and now am ready to get back on TRT.

I couldn’t nail the exact protocol last time due to adding HCG +HMG + Proviron + DHEAs at the same time as TRT which shot my E2 through the roof.

It didn’t help recover my fertility nor resolved my symptoms ( even though it improved a bit ) so that’s why I stopped.

My main symptoms before TRT and right now are low libido and ED. Ah, I am a 34 year old male, fit and workout 5 days a week.

On the protocol that I am going to start now and that I discussed with my doctor, we are going to add HCG in order to preserve fertility.

What he suggested to me was:

25mg T Enanthate EOD ( 100mg / week )
150 IU HCG EOD ( 600 IU / week )

To be mentioned that naturally I am a low SHBG / low E2 guy.
I am attaching here my blood tests I did 2 days ago.

Thoughts on the protocol overall and if you think TRT is the solution to my ED problems?

25mg EOD is only 87.5mg not 100mg. 150IU HCG EOD is 525IU not 600IU.

I would be surprised if that was enough T to get you into the upper level. HCG will help with T levels but can also push E2 levels. I wouldn’t add the HCG now, there is enough literature out there showing you can add it in at a later stage to address fertility.

Rather do the Dr suggested T, get tests again around 6 weeks, assess how you’re feeling and see bloods. Then increase or decrease dose to arrive at a good spot. Add HCG when needed.

Agree with the prior post. Check your math.
(25/2) X 7 = 87.5mg/week T-eth
(150/2) X 7 = 525 IU/week HCG

Regarding the starting protocol, you will probably find this will boost your T, but you will probably be happier with a higher dose. Assuming your doc buys into upping the dose, I recommend increasing it to at least 30mg EOD (105mg/week) and then retest in 6 weeks. I recommend you shoot for getting Free T in the upper 75th percentile of a 20-30 year old man. You may have to do one or two 20mg/week dose adjustment after that. Always give your system at least 6 weeks to stabilize and then retest and make adjustments based on the labs.

Regarding HCG, given that your goal is maintaining fertility, I recommend increasing the dose to about 1000 IU/week. There are 2 good studies that show this is about the right amount to overcome testicular suppression as measured by intratesticular testosterone levels (ITT). See the graph below.

I would not worry about E2. My experience with 1000 IU per weeks indicates that it will not affect E2 levels. I believe this has been repeated over and over in the forums to the point where it’s taken as the “truth”? but where’s the evidence? My experience is to the contrary. E2 is a difficult hormone to measure, it bounces around a lot, and too many guys get their undies in a bundle over it. It’s not the evil hormone it’s made out to be. Guys need E2 too for normal libido and erections.

Sorry for the confusion, my protocol is 100mg T / week and 600 IU HCG / week. I thought EOD meant 4 times per week.

I also think I should go for 1000 IU HCG per week but don’t know how to split it to minimize E2 spikes. Each HCG vial is 1500 IU. In the past injecting 1500IU in one shot gave me bad sides so I dont want to go in big one shot doses.

Also my doc was fine to give me up to 200mg / week but I told him I want to start low ( since Im low SHBG ) and increase it needed later on.

This is not 100mg, it’s 87.5mg, just FYI [quote=“rimseb, post:5, topic:268206”]
I thought EOD meant 4 times per week.
[/quote]

30mg EOD is 105mg, prolly as close as you can get. 4 shots one week, 3 shots the next

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I suggest that the HCg be broken up into at least 3 injections per week. The studies that were the subject of the graph used and E2D (every 2 days) protocol. My standard protocol is 450 Iu E3D. This works well with E3D T-cyp injection protocol. Injections are always on the same day, so it just makes administration easier.

I support your approach on starting low and increasing the dose until there is complete symptom abatement. In my case that occurs around 125mg/week, but everyone is different. I’m at the opposite end of the SHBG spectrum. My SHBG is typically in the 80+ nmol/L range. With low SHBG, you will probably do better on a more frequent injection cycle than longer intervals, or at least that what a number of guys with low SHBG I’ve communicated with have said.

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Thanks for the detailed reply, very useful.

I am thinking of going with HCG 150IU every day for a month (1050 IU / week ) and do a sperm analysis to see if it’s working as it should.

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The way I figure out EOD dosing:

30mg EOD would be:

30x15 divided by 4. 112.5mg per week.

15 is the number of times per month you inject. Then divide by 4 weeks per month.

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30mg EOD -> 30x7 (7 shots every 2 weeks) 210 / 2 weeks = 105mg weekly. It won’t line up right if you go off monthly shots, since some months will have more days than others