Estradiol too high when using HCG

[gaiao]

Hello everyone! I’m 21, Ive been suffering from ED, depression, no morning wood, weak nocturnal erections and low libido for a long time, and I was never able to build muscle no matter what. So, in june, I finallly decided to see an Urologist to treat the ED.
I had lots of tests done, and the blood tests showed:

Free Testosterone: 0.51 (0.95-4.30)
Total testosterone: 392 (300-1000)
FSH: 1.7 (1.7-11.2)
LH: 1.7 (1.7-11.2)
Estradiol: <25 (20-75)

The other hormones were normal.

He said that the low testosterone was possibly the cause, and that he would put me on HCG and see what happens. I was supposed to take 1500 usp 3 times a week. And come back in 6 weeks to see what happened.
During the second week I was feeling much better, erections were better but not quite good yet. My nipples were a little sore. The blood work after the 6 weeks was:


Free Testosterone: 3.79 (0.95-4.30)
Total testosterone: 1557 (300-1000)
FSH: <1.0 (1.7-11.2)
LH: <0.2 (1.7-11.2)
Estradiol: 116 (20-75)


Seeing that, he reduced the dose to 1000 usp 3 times a week. After that I had to move back to Brazil, and I’ve been trying to find a good endo.
I went to another urologist, he asked more blood work and I got this:

Free Testosterone: 22.7 (3.4-24.6)
Total testosterone: 1041 (241-827)
Estradiol: 223 (<39)

When estradiol was that high, my nipples were very sore, and I had no libido at all.

Then he said I was still taking too much hcg, and lowered the dose to 500 usp 3 times a week.
I was on this dose for 2 weeks, my erections were better, I felt better but my nipples were VERY sore, I couldnt even touch it. So I lowered the dose to 400 usp 3 times a week on my own, I was very afraid of getting men boobs.


Then I found a good endocrinologista (I guess).
He ordered an MRI (it seems I have a tumor in my pituitary gland, he said its nothing to worry about, its pretty common), an ultrasound of my testicles (everything is fine down there), an ultrasound of my nipples (everything is ok)
And more blood work (for a lot of things this time):

Free Testosterone: 18.75 (3.4-24.6)
FSH: 1.14 (1.6-8)
LH: 0.46 (1.7-11.2)
Estradiol: 105 (<39)
Vitamin D: 24.7 (30-100)
Calcium: 4.18 (4.60-5.40)

The other hormones and vitamins are ok. This last test was done 2 days after I lowered the dose from 500 to 400 usp. So I think the results are not shown here. I just don’t know why my estradiol is still so high. My nipples don’t hurt anymore, and my erections are better. But they still fade too quickly and are not rock hard.
The doctor wants another blood test done in a week just to confirm the last results, if the estradiol increases or keep the same, he will lower the HCG dose even more.
Or he will stop the medication and see what happens.
I’m just so lost, I don’t want to stop the medication and feel like shit again. I don’t understand why the Estradiol levels don’t go down, since my free test is in normal range... I’m afraid that if I lower the dose even more, the testosterone can get too low... I just want to have a testosterone level normal for a 21 years old!!

Does HCG induces the production of Estradiol? Or is it because my testosterone went too high and then got converted?
Does anyone have any idea? Any suggestion? Should I ask him for an AI?

 

[idmd]

Yes....hCG is NOTORIOUS for causing high E2. Your hCG is too high (and ultimately suppressive to your HPT axis), your test is too high, your E2 is too high, your taking hCG too often.

Your endos don't seem to have a clue. What's your diagnosis? What's the plan moving forwards?

 

[gaiao]

Yes....hCG is NOTORIOUS for causing high E2. Your hCG is too high (and ultimately suppressive to your HPT axis), your test is too high, your E2 is too high, your taking hCG too often.

Your endos don't seem to have a clue. What's your diagnosis? What's the plan moving forwards?

Thanks for the reply!

I was diagnosed as secondary. I did 2 MRIs, the first one didn't show anything wrong, but the second (done last week) showed I have a lesion on my pituitary, I will have a third MRI done later this year.

My endo asked me to repeat the blood test this week just to check if my levels are still high after 2 weeks on 400 usp... He will lower the dose even more if its still high.

So HCG causes high e2? But that is because my test is high right? because according to what I read, HCG mimics LH...
Do you think taking HCG every 2 days would solve the problem? Would that make my test levels vary too much? I want to keep my levels as stable as possible, no rolling coaster effect.
I will tell my doctor everything I've been reading here and in other places...

Thanks!

 

[LW64]

HCG only for testosterone replacement can raise some problems which, for some men, are not fixable.

When you take testosterone only, it gets converted peripherally to estradiol [E2] and that is what shuts down your HPTA.

When you take HCG, here's what happens:

[1] If you're secondary (and you are) it takes the place of LH and stimulates the testicles to produce testosterone

[2] That testosterone is converted by the aromatase in the testicles to estradiol

[3] The testosterone that circulates out of the testicles into the body gets converted peripherally to estradiol.

[4] HCG stimulates the production/activity of aromatase.

For these reasons you can see why you're getting elevated E2 and need to find the MINIMUM amount necessary to keep your Free T in the normal range without your E2 level going batshit. Keep in mind that it may not be possible to do this.

Here are some options:

[1] Try something like 700 IUs every 3 or 4 days. With HCG, it's possible that less frequent, high doses will work better than multiple, smaller doses. Then again, it may not. You need to try it for a month or two, get labs, and go from there.

[2] Go on testosterone replacement - gels or injections - but add in some HCG once or twice a week to maintain testicle size and maintain fertility. There are more than a few men here who are doing this with good results - including me.

You're quite young to have such low T. Have you and your doctor taken a very close look at what may be causing it? What, if any, other health issues are you dealing with? Prescription drugs? How bad is the depression?

 

[Cyberwolf]

Did you use steroids in the past?

 

[hardasnails1973]

Look at lifestyle.
Do you sleep 8 hours feeling well rested in the morning or are you out drinking and being a party animal.
Let me guess you sleep with cell phone next to your head and computer near by? Hcg is great providing the root cause is identified. 21 year old is typical lifestyles as main culprit vast majority of the time.

 

[gaiao]

HCG only for testosterone replacement can raise some problems which, for some men, are not fixable.

When you take testosterone only, it gets converted peripherally to estradiol [E2] and that is what shuts down your HPTA.

When you take HCG, here's what happens:

[1] If you're secondary (and you are) it takes the place of LH and stimulates the testicles to produce testosterone

[2] That testosterone is converted by the aromatase in the testicles to estradiol

[3] The testosterone that circulates out of the testicles into the body gets converted peripherally to estradiol.

[4] HCG stimulates the production/activity of aromatase.

For these reasons you can see why you're getting elevated E2 and need to find the MINIMUM amount necessary to keep your Free T in the normal range without your E2 level going batshit. Keep in mind that it may not be possible to do this.

Here are some options:

[1] Try something like 700 IUs every 3 or 4 days. With HCG, it's possible that less frequent, high doses will work better than multiple, smaller doses. Then again, it may not. You need to try it for a month or two, get labs, and go from there.

[2] Go on testosterone replacement - gels or injections - but add in some HCG once or twice a week to maintain testicle size and maintain fertility. There are more than a few men here who are doing this with good results - including me.

You're quite young to have such low T. Have you and your doctor taken a very close look at what may be causing it? What, if any, other health issues are you dealing with? Prescription drugs? How bad is the depression?

The second MRI we did pointed that I have a small lesion (tumor) on my pituitary.. Its not necessary (or recommended) to remove it. Other than this hormonal problem, I've always been fairly healthy. I don't take any other kind of drug.
The depression was pretty bad before I started the treatment, I didn't want to do anything, could barely get out of bed. But now its gone, sometimes I get sad for stupid reasons/small things, maybe thats because of the estrogen...

On my next appointment I will discuss the information I gathered here, I've already considered test injections (my doctor even said it would be so much easier and cheaper), but he would want to put me on monthly injections (he said that in Brasil thats the normal procedure, I don't believe that though). I don't plan on having children, so the infertility is not a big deal for me, the aesthetics would bother a little, but it doesn't matter if my tool works well hahah.

I will have another Blood test tomorrow, and I will post the results once I get them.

Did you use steroids in the past?

No.

Look at lifestyle.
Do you sleep 8 hours feeling well rested in the morning or are you out drinking and being a party animal.
Let me guess you sleep with cell phone next to your head and computer near by? Hcg is great providing the root cause is identified. 21 year old is typical lifestyles as main culprit vast majority of the time.

I don't drink or smoke, Ive never used drugs. I usually don't go to parties.
I also workout 4 times a week (average of 1h and 30 min every time).
I try to eat healthy, my weight is 154 lbs and my height is 6'0". So I'm fine.
I try to get 8 hours of sleep, but I usually get around 7-7:30.


Thank you very much for all the help!

 

[LW64]

I don't plan on having children, so the infertility is not a big deal for me, the aesthetics would bother a little, but it doesn't matter if my tool works well hahah.

You're WAY too young to make that decision so conclusively. Many, many things can and will happen in the next 20 years that can change your mind. TRT isnt a birth control method anyway - IOW your fertility may be reduced but it wont go away completely even with only T shots. OTOH you might not like to have disapperaing balls as much as you might think.

 

[idmd]

the aesthetics would bother a little

Thank you very much for all the help!

Yeah that's what I thought until it happened to me and then it bothered me A LOT! They get high and tight and my scrotum was so tight it was uncomfortable. Now they are low and hanging and I can feel them swing during sex and that rocks!

 

[gaiao]

You're WAY too young to make that decision so conclusively. Many, many things can and will happen in the next 20 years that can change your mind. TRT isnt a birth control method anyway - IOW your fertility may be reduced but it wont go away completely even with only T shots. OTOH you might not like to have disapperaing balls as much as you might think.

You are right. and I didn't know that I would still be fertile...
If its the hcg that causes the high e2, wouldn't combine it with test shots be the same thing?
If my BW tomorrow points that my e2 is still high (I'm pretty sure it is, I can feel it).
I will lower the dose from 400 to 300 usp, or even 250 usp 3 times a week.

Yeah that's what I thought until it happened to me and then it bothered me A LOT! They get high and tight and my scrotum was so tight it was uncomfortable. Now they are low and hanging and I can feel them swing during sex and that rocks!

Oh, Did it hurt? or was it just like you were wearing a VERY tight underwear?

That swing feeling is awesome haha, I would definitely miss that.

 

[LW64]

You are right. and I didn't know that I would still be fertile...
If its the hcg that causes the high e2, wouldn't combine it with test shots be the same thing?
If my BW tomorrow points that my e2 is still high (I'm pretty sure it is, I can feel it).
I will lower the dose from 400 to 300 usp, or even 250 usp 3 times a week.

When you combine HCG with T shots, you only take a small amount of HCG once or twice a week. You can also try T only most of the time and come back to HCG (only or mixed with T shots) to get your testicle size back. So you would do something like T shots only for 3 weeks then go on HCG only for a week, then back to T only.

I think you've got your aromatase lit like Christmas tree right now so it would be best to go on T shots only for a while. Stop taking HCG, wait a week, then try 50 mg of Testosterone twice a week and get labs at the end of a month. Then adjust your dose to get your Free T into the middle of the normal range. You will need to know your Sex Hormone Binding Globulin (SHBG) if you dont already from previous blood work results. Then use this calculator:

Free & Bioavailable Testosterone calculator

to adjust your dose. You want to aim for a Free T of 16 ng/dL which is about the middle of the normal range of 10 to 25 on the scale used by that calculator. Dont bother with a Free T lab analysis of your blood sample - it isnt very accurate.

Once you have your T level worked out, you can add in somthing like 200 IUs of HCG twice a week...and then you will also need to lower your T dose to compensate for the T that you will produce yourself due to the HCG and to keep E2 under control. Do this for a month, get labs for tT and E2 and adjust from there....

 

[gaiao]

Thank you very much!
I have so much to discuss with the doctor now hahaha

 

[idmd]

You are right. and I didn't know that I would still be fertile...
If its the hcg that causes the high e2, wouldn't combine it with test shots be the same thing?
If my BW tomorrow points that my e2 is still high (I'm pretty sure it is, I can feel it).
I will lower the dose from 400 to 300 usp, or even 250 usp 3 times a week.


Oh, Did it hurt? or was it just like you were wearing a VERY tight underwear?

That swing feeling is awesome haha, I would definitely miss that.

It was uncomfortable and my testicles looked prepubescent......tight and wrinkled....lol

 

[gaiao]

I have one more question:

What about clomid? does it prevent testicle atrophy like hcg? I ask that because I've been looking like crazy for hcg in Brazil. But it seems the only kind I can find here is the one used for fertility (its just one dose, medicine spoils 4 hours after mixing). I called the pharmacies I knew in the US, but they don't ship it here.
The brazilian pharmacies my doctors told me to call don't have these medicine either...
Fortunately I still have enough for more than a month. And in january i will be back in nyc so I will get enough for a year hahah.

 

[gaiao]

I got a new blood work done yesterday, the result are as follow:

Estradiol: 90,5 (11,6 - 41,2)
Free testosterone: 23 (2,62 - 16,7)

With these results, I decided to stop taking HCG for a week, then resume but lowering the dose I take from 400 usp to 200 usp 3 times a week.

I will do that until I meet my endo in 15 days.

 

[Cyberwolf]

I have one more question:

What about clomid? does it prevent testicle atrophy like hcg? I ask that because I've been looking like crazy for hcg in Brazil. But it seems the only kind I can find here is the one used for fertility (its just one dose, medicine spoils 4 hours after mixing). I called the pharmacies I knew in the US, but they don't ship it here.
The brazilian pharmacies my doctors told me to call don't have these medicine either...
Fortunately I still have enough for more than a month. And in january i will be back in nyc so I will get enough for a year hahah.

Yes, but clomid is not for ever because has bad side effects ,eye floaters , vision problems mood changes hot flashes and it can actually lower sperm count and sperm motility and other...