HCG Only Protocol and Secondary Hypogonadism

[SWALE]

Further, for those who use HCG as sole TRT, it must be administered every day. The body thrives on regularity. Taking it twice, or even just three times per week, makes absolutely no sense (when used as sole TRT).

I have my guys take theres in the morning. Then they may enjoy the subjective benefits all day long.

I have a few patients whose E went too high by the time I got them where we wanted them to be with respect to serum androgen levels while on T gel. So I cut the dose, added in DAILY HCG, and man, do they love it. T goes up, E stays down, the testes maintain better size, P450scc enzyme is stimulated in their HPTA-suppressed state, and their libido goes through the roof. I think this is actually the best TRT protocol there is.

Again, some of the "big guys" in my field would disagree with me. But I do not believe they can adequately defend their protocols given the points I have made.

But let them try--this is how science marches on.

 

[DLMCBBB]

Dustin,

The key conclusions that I reach from this (and other) studies are:

(1) HCG generates a biphasic T response. That means that (at least) 2 peaks in T are observed after an HCG shot. One that occurs 2-7 hours after the shot, and one that occurs 48-72 hours after the shot.

What causes a second peak? (My guess is that before you read this article you assumed that there was only one peak. Correct?)

While the abstract doesn't say what causes the second peak, my doctor (Dr. Shippen), told me that the second peak (of the "biphasic" response to an HCG shot) is caused by an LH burst produced by the H/P axis. In other words, the H/P axis responds to an HCG shot with an LH burst about 2 days later. Pretty interesting, eh?

(2) Men with secondary hypo don't respond well to their first HCG shot(s). In other words, it takes time for the Leydig cells to be restored their full capability.

Yes I assumed there was only one peak, because in the studies I have seen in the past, LH had a single peak, whereas hCG has two.

But im leaning on the side of swale's comments in regards to "downregulation" with high dosages of hCG.

This biphasic pattern possibly is being attributed to the observation that between 24 and 48 hours after an LH or hCG injection, the Leydig cells are refractory to further stimulation by either hormone. The second phase of testosterone secretion after hCG but not LH, is most likely associated with the longer half-life of hCG in comparison to LH. The hCG levels persist in the circulation and, following recovery from the refractoriness, testosterone levels increase.

I have never seen hCG "priming" the HP ever.

Dustin

 

[SWALE]

I think Dustin is right on the money.

 

[DavidZ]

I do not believe what Dr. Shippen claims has ever been shown. At least, not to my knowledge. If it has, I would be VERY much interested in seeing it.

In fact, the well-known biphasic response has never been shown to occur at APPROPRIATE HCG dosages--only toxic ones. Again, this is to the best of my knowledge.

I agree that all of these studies use way too much HCG for our purposes.

I would instead hazard a guess that the biphasic response is proof of LH receptor downregulation. And LH receptor downregulation has been well demonstrated.

Your explanation is very reasonable.

The best use of HCG in TRT, IMPO, is adjunctive to either test cyp or test transdermal--used to stabilize serum androgen levels, stave off testicular atrophy (the best it can), stimulate the P450scc enzyme, and lend the increased sense of well-being and libido HCG is so well known for.

I'm open to that.

My current HCG dosage is 410 IU/week. That dosage (plus about one quarter of a 120 mg Indolplex tablet per day) puts my T, Free T, and E2 consistently in the upper normal range. Since this HCG dosage is less than the bottom end of the range for HCG in your combo protocol (250 IU 2x/week = 500 IU/week) what dosages and timing of HCG and T gel would you suggest for me?

Also, I'm confused because, your protocol calls for HCG every third day for those who are on T gel, but a recent post indicated daily HCG doses.

This is a smokin' hot thread.

Yes, it is. Thanks for your input and knowledge!

 

[SWALE]

You are entirely welcome.

It loks as though your protocol is where you need it to be. I would go to daily doses of HCG, at the same total weekly dosage, though. I would also make sure to drop your E into midrange.

It doesn't look as though you had very far to go with respect to your T range when you started.

True enough, sneaking in a little HCG every third day while on a transdermal will cause fluctuations in serum andorgen levels. I have experimented with a protocol where the patient uses a transdermal for two days, then HCG the third day (no T gel then), as well as variations of this basic theme. I'm just not sure yet how best to work it.

The protocol I mentioned has small doses of T gel every day, along with small doses of HCG QD. That is a different regimen entirely. Some guys just do not want to inject every day, even SC.

 

[DavidZ]

It doesn't look as though you had very far to go with respect to your T range when you started.

Actually, I was quite low. My 3 blood tests for T before starting HCG were 188, 329 and 121.

For whatever reason, I seem to respond to small dosages of practically everything.

Thanks again for your comments. It's a lot to ponder for now.

 

[forex]

You are entirely welcome.

It loks as though your protocol is where you need it to be. I would go to daily doses of HCG, at the same total weekly dosage, though. I would also make sure to drop your E into midrange.

It doesn't look as though you had very far to go with respect to your T range when you started.

True enough, sneaking in a little HCG every third day while on a transdermal will cause fluctuations in serum andorgen levels. I have experimented with a protocol where the patient uses a transdermal for two days, then HCG the third day (no T gel then), as well as variations of this basic theme. I'm just not sure yet how best to work it.

The protocol I mentioned has small doses of T gel every day, along with small doses of HCG QD. That is a different regimen entirely. Some guys just do not want to inject every day, even SC.

I have been on an HCG only as my only form of TRT for 3mos now, I have felt a bit in a cloud and have yet to achieve that feeling of well being I keep reading about. My libido increased out of the gate to the level og a 18 year old durring my first week... ever since then it is at the level of a late 20's male. Overall I am not pleased with how I feel on my present course of TRT.

I am 33, 225lbs- and on 1iu HGH Daily and 535units of hgh Daily (I think this is too much). B-4 I began therapy 4 mos ago my Free T was 49 (scale of 50-210), my E2 was 52 (scale of 10-50) an IGF-1 of 165.

After my last blood test 6 weeks ago (next one is tomorrow), my Free T is at 180 (scale 50-210) and E2 96 (scale 10-50) too high- and IGF-1 at 266 which is a good level to be at (250-350 range).

Since joining your discussion group I have learned a lot, Swale I thank you for that

I will see my Doc next Fri. and would like to try and sell him on your daily T-Gel and daily hCG protocol (because; as I have posted on another thread my Doc will not give me Test Depot ) Based upon the numbers I have posted here, how much of each on a daily basis would you reccomend I introduce to my Doc next week?

Thanks again for this wonderfull knowledge base.

 

[DavidZ]

I have been on an HCG only as my only form of TRT for 3mos now, I have felt a bit in a cloud and have yet to achieve that feeling of well being I keep reading about. My libido increased out of the gate to the level og a 18 year old durring my first week... ever since then it is at the level of a late 20's male. Overall I am not pleased with how I feel on my present course of TRT.

My experience on HCG for 5 years is that it's very difficult to get the dosages right to maintain your T and E2 in the proper range.

After my last blood test 6 weeks ago (next one is tomorrow), my Free T is at 180 (scale 50-210) and E2 96 (scale 10-50) too high- and IGF-1 at 266 which is a good level to be at (250-350 range).

The problem with blood tests is that they represent a single point in time. The don't tell you anything about fluctuations over time.

Since joining your discussion group I have learned a lot, Swale I thank you for that

Me, too.

I will see my Doc next Fri. and would like to try and sell him on your daily T-Gel and daily hCG protocol (because; as I have posted on another thread my Doc will not give me Test Depot ) Based upon the numbers I have posted here, how much of each on a daily basis would you reccomend I introduce to my Doc next week?

Thanks again for this wonderfull knowledge base.

I'm going to take Swale's suggestion of dividing my weekly HCG dosage up into daily dosages. If you know how much HCG you take a week, just divide that amount by 7 and that's a good starting point for your daily dosage if you want to go HCG only.

If you want to add T gel you'll need to adjust the HCG downward, accordingly. It's impossible to know how much T gel offsets how much HCG, because each man absorbs T gel at a different rate and each man responds to HCG at a different rate. You'll just have to take a good guess and then adjust based on blood tests and how you feel.

 

[pmgamer18]

I am wondering what works better with Hcg shots or gels.
Phil

 

[SWALE]

Forex--That's an awful lot of HCG to do each day. I'd like to see where your E's are at, and also progesterone. If your progesterone is elevated, it will oppose DHT, thus undermining ALLTHINGSMALE.

DavidZ is right on the money with his comments on titrating HCG. That is why HCG should be supplemental to TRT, not as sole TRT.

 

[forex]

Thanks to both DavidZ and Swale.

I just had my bloodwork tested Friday (4-1-05), I see my Doc this Friday the 8th to go over it with him; at that point I will also post all of my levels including progesterone (if it was tested). Where should my progesterone levels be?

Thanks for your concern Swale (I think I am on too much hCG too), I'll be back here with my results by this weeks end.

Have a great week guys!!

 

[Kroms_laugh]

So to answer my question;
HCG only protocol isn't optimal treatment?

"Test is best" - SWALE

 

[rjsiwelhj]

HC daily or not?

Thanks for the excellent and informative posts Swale, David and others.

I am still confused about one thing.

When coupled with daily non injected T supplementation, in your opinion, is it best to administer HCG daily or a couple injections per week. Let's assume daily injections don't bother the therapy recipient.

Thanks for any input.

 

[forex]

So to answer my question;
HCG only protocol isn't optimal treatment?

"Test is best" - SWALE

Based on my knowledge of the subject and what I am going through, I do not think it is an optimal solution. However on the same token; I have yet to try another form of TRT so I do not think I am able to give it a fair comparison, or give you a fair answer. I will be able to help more once I gain more history with TRT...

 

[Matt Muscle]

My libido increased out of the gate to the level og a 18 year old durring my first week... ever since then it is at the level of a late 20's male. Overall I am not pleased with how I feel on my present course of TRT.

I am 33, 225lbs- and on 1iu HGH Daily and 535units of hgh Daily (I think this is too much). B-4 I began therapy 4 mos ago my Free T was 49 (scale of 50-210), my E2 was 52 (scale of 10-50) an IGF-1 of 165.

After my last blood test 6 weeks ago (next one is tomorrow), my Free T is at 180 (scale 50-210) and E2 96 (scale 10-50) too high- and IGF-1 at 266 which is a good level to be at (250-350 range).

.

Hi Mate.. your libido is currently that of someone in thier late 20's and your 33... your not happy with this? May I say that expecting your libido to stay like an 18 year olds is perhaps asking too much...

Yes 535 units of HCG daily is way too much and will cause problems... i have tried this myself.. very likely a result of estrogen and progesterone as Swale says.

 

[SWALE]

Krom--You have not noticed all the times I have stated that HCG as sole TRT does not provide the subjective benefits of TRT?

 

[Kroms_laugh]

Krom--You have not noticed all the times I have stated that HCG as sole TRT does not provide the subjective benefits of TRT?

Too be honest, this is the first time I've really looked into it.

Selective reading, Doc.

/moves to the front row, assumes a straighter posture/

 

[SWALE]

I'm trying to come up with some clever, yet smart-alecky comment, but cannot.

Sorry.

 

[forex]

Hi Mate.. your libido is currently that of someone in thier late 20's and your 33... your not happy with this? May I say that expecting your libido to stay like an 18 year olds is perhaps asking too much...

Yes 535 units of HCG daily is way too much and will cause problems... i have tried this myself.. very likely a result of estrogen and progesterone as Swale says.

Thanks Matt- I am happy with the libido.

What I meant was that I am not happy with the other feelings I am having; ie-mental cloudieness or lack of clarity, being tired, puffy fingers, excess H2O weight, the inability to shead my fat. Those are a few of the things that I am not pleased with.

 

[forex]

I'm going to take Swale's suggestion of dividing my weekly HCG dosage up into daily dosages. If you know how much HCG you take a week, just divide that amount by 7 and that's a good starting point for your daily dosage if you want to go HCG only.

If you want to add T gel you'll need to adjust the HCG downward, accordingly. It's impossible to know how much T gel offsets how much HCG, because each man absorbs T gel at a different rate and each man responds to HCG at a different rate. You'll just have to take a good guess and then adjust based on blood tests and how you feel.

Thanks David, You seem to have an excellent knowledge of this subject. In order for me to present this properly to my Doc I have 2 questions for you (if you would be so kind) the answers you give me will help me in comming up with a starting point for the t-cream & hCG protocol.

1- How much (i know 500iu a day is WAT too much) hCG would be a good starting point each day, approx. range?

2- How much t-cream each day, again approx.?

Thanks again, I am seeink my Doc Friday, so hopefully he will work with this protocol.