My introduction.....

[idmd]

Dr. S.....you had me at:

 

[toolman]

toolman,

Nothing more than curiosity and a touch of laziness. I've moved away from the good Dr. H and haven't found a new doc and was running low on test and figured what the hell...why not try and see if I can restart? It was easier to get my hands on clomid and tamox than go through what will be the arduous task of getting hooked up with a new doc. If I have to then I have to - just wanted to see what would happen.

All other medical issues resolved. I've kept the weight off, still eating well, still exercising, feeling good with no issues. Still feel good even during this restart attempt.

How are you doing toolman?

Glad to hear the weight is off and all else is fine. I stopped using Dr. H as I spend most of the year at my southern residence. Haven't seen snow in two years now and do not miss it at all. Other than upping my dose to 160 mgs a week that screwed things up, upon the advice of my new and Ex urologist, I have been doing great on 120 mgs weekly and 5 mgs daily Cialis. I give blood every quarter and all numbers are ideal and feeling awesome.

I understand the laziness, it does get to be a pain in the ass to remember to do injections, but I went the restart route to no avail. Good luck with it and good to see you around again!

 

[toolman]

Thanks for taking the time to post this!

Alright sworder please remove the proboscis from his rectum...

 

[Sworder]

Alright sworder please remove the proboscis from his rectum...

Scally is basically helping people here for free lol. A man of his stature in the HRT forum taking time to post to help people deserves to be thanked. I was just thinking to myself, why am I spending time writing to this guy to help him.... I gotta do dishes...

Proboscis

 

[Michael Scally MD]

It is not known if hCG will help or not. But, hCG is ~85X more biologically active than LH. I have seen cases where a SERM was marginally effective that improved with hCG. This is what is bothersome. The lack of studies for functionality/recovery.

I do think it wise to check for HPTA Functionality/Restoration every 18-24 months during TRT.

At 275, what is your waistline?

 

[foreveryoung]

That's option 1. and no the doses of hCG are not equivalent to LH. The hCG you can use will be much stronger than the current LH.
That's why you use hCG because you can STIMULATE the leydigs, it doesn't Desensitize them... Why would Dr Scally come up with these doses and durations if it would? The guy is a genius...

You cannot desensitize leydigs with endogenous LH...

my fault for wording my post carelessly in my haste, I didn't say that the dose of hcg is equivalent to LH, I said "way supra equivalent" which was my poor grammar for trying to say that the hcg dose would be extremely high compared to natural LH activity

and what is your point about "desensitize leydigs with endogenous LH"? that seems fine and is in support of the natural non-hcg method, but I wonder why you bring it up when you are espousing the blasting of high activity Hcg on the testicles?

I still believe that hcg can desensitize the leydigs, stimulating them short term and desensitizing them after are two different concepts.... the way glands and other biological processes work in the body seem to make it logical that overstimulation above what is natural has a longer term desensitizing effect... you wouldn't tell an alcoholic to blast his dopaminergic system with more alcohol to prepare himself for quitting, just as I would never blast my testicles with hcg when my body is already producing a strong natural LH signal on it's own already, the chance of desensitizing the leydigs as well as creating the environment to suppress the pituitary signal seems like a double whammy of making Hcg a bad idea in this situation

 

[Sworder]

I still believe that hcg can desensitize the leydigs, stimulating them short term and desensitizing them after are two different concepts.... the way glands and other biological processes work in the body seem to make it logical that overstimulation above what is natural has a longer term desensitizing effect... you wouldn't tell an alcoholic to blast his dopaminergic system with more alcohol to prepare himself for quitting, just as I would never blast my testicles with hcg when my body is already producing a strong natural LH signal on it's own already, the chance of desensitizing the leydigs as well as creating the environment to suppress the pituitary signal seems like a double whammy of making Hcg a bad idea in this situation

Refer to the study Scally posted, the desensitizing leydigs is exaggerated and thrown out of what I seem to be nowhere whenever hCG is mentioned.

Just, what is the point of a strong LH if the Leydig cells aren't responsive?

 

[toolman]

Scally is basically helping people here for free lol. A man of his stature in the HRT forum taking time to post to help people deserves to be thanked. I was just thinking to myself, why am I spending time writing to this guy to help him.... I gotta do dishes...

Proboscis

Lol...glad you understood the joke that it was...so many guys in here are so damn sensitive. Good to see you are not among them!

 

[foreveryoung]

Ha! Pee pee is completely dead this morning. Wife rolled over to give me head and the best he ever got was about 25%. No feeling at all - feels numb?

I didn't experience this PRE-TRT with a tT of 150.

Gonna take 0.5mg Adex.

Which is why I often mention in the forums that often low normal testosterone is preferable to trt when it comes to libido and function in many and it's not so simple

Curious how you made out with your AI experiments over the long run?

 

[idmd]

Foreveryoung...I had been doing just 50mg test cyp twice weekly with no AI and I have not had ANY problems. Pee pee hasn't failed me one time since I settled into that dose and I had morning wood every day with strong libido.

Even now on SERMs I'm performing as usual with good libido. If I had to say something maybe taking a little longer to finish but able to retain strong erection the entire time.

Actually had to wait 3 mins to get out of the car this AM to go to breakfast because I had a boner....

That said I've always been lucky with E2. Off AIs I always hover around 20-26. I've changed my test doses, I've lost 70lbs, went from sedentary to active and little changed with E2. Even now on SERMs I'm at 24. I've actually never had a single E2 reading above 26 (that I can remember). I don't think E2 has ever been part of the equation for me.

To be honest part of the reason I stopped coming here was my protocol was simple, easy and working well....I had no problems. If this restart doesn't work it will be easy to go back to it.

 

[foreveryoung]

Oh ok, so it was when you tried to do any experiments at all with arimidex is when you lost all erection ability

 

[idmd]

It's hard to remember exactly but I know when I decided to stop using AIs my libido and erections all stabilized to a more than acceptable level.

For me I feel 100x better now than I did with tT of 150 but I have not needed to do anything other than inject test cyp to feel good.

 

[toolman]

It's hard to remember exactly but I know when I decided to stop using AIs my libido and erections all stabilized to a more than acceptable level.

For me I feel 100x better now than I did with tT of 150 but I have not needed to do anything other than inject test cyp to feel good.

Ditto, T alone was enough for me. Started the Cialis due to minor BPH symptoms but I have to say, whether I am in the mood or not, the Cialis makes it so my mind is no longer required in the equation.

 

[foreveryoung]

interesting, so it seems some reporting the most success are those keeping testosterone dose low like in the 100mg per week range

 

[LW64]

I recall idmd, for a time, also used HCG twice a week along with his T injections and that worked well for him too.

 

[idmd]

I did LW64 in the beginning but it didn't add anything in the end. In the my simple injection on Sat and Wed did the trick. I felt good enough that I stopped obsessing on how I was feeling

 

[Northern Nutrition]

Finally, there is an excellent study on down-regulation modeling. This paper has some good modeling graphs. I use 1,000-2,000 IU E3D now.

"The model we developed allows us to simulate arbitrary dosing schemes. The example we provide shows an informal way to obtain a maximum response while using the minimum amount of drug. The simulated testosterone levels show that to reach a target testosterone concentration of 25 nmol/liter [~720 ng/dL], a dose of 1000 IU of rhCG every other 4 days would be sufficient. A higher 2500 or 5000 IU dose would produce a slightly higher response, but the highest dose will produce a lesser response according to the model. Clearly, the predicted pattern of decreased response at high doses and the pronounced rebound effect at treatment cessation is intriguing. The extrapolation to a clinical setting certainly deserves confirmation."

Gries JM, Munafo A, Porchet HC, Verotta D. Down-regulation models and modeling of testosterone production induced by recombinant human choriogonadotropin. J Pharmacol Exp Ther 1999;289(1):371-7. http://jpet.aspetjournals.org/content/289/1/371.full

Chorionic gonadotropin (CG) is a glycoprotein hormone, whose action is mediated by the luteinizing hormone/CG receptor. Testosterone concentrations from six pituitary-desensitized, healthy male volunteers were obtained after four different administrations of recombinant-human CG (rhCG). We present a modeling study to provide a possible explanation for the observations that increased exposure to rhCG induces higher and then lower testosterone concentrations and that marked rebound effects are observed at the end of repeated administration of rhCG. We used semimechanistic models (in which flexible functions represent unknown parts of the models) to identify the relationship of rhCG concentrations to the testosterone levels. Based on the results obtained with the semimechanistic models, different mechanistic down-regulation models were devised and tested. The final model uses a one-compartment model to describe the endogenous production rate of testosterone; rhCG affects the production rate with a mechanism consistent with a two-site binding site, with effect proportional to one-site bound concentration. The modeling results indicate that when rhCG concentration increases, the testosterone production rate increases to 45 times the baseline value. However, at an rhCG concentration of more than about 30 IU/liter, the production rate decreases. Simulations showed that both dose and dosing interval profoundly influence testosterone response to rhCG.

Since both volume and frequency (like i indicated in the other thread) effect the outcome, is it not safe to suggest that more frequent dosing and less volume can produce similar outcomes to less frequent and increased dosages?

Not challenging you, simply asking for your opinion based upon these studies.

 

[Michael Scally MD]

Since both volume and frequency (like i indicated in the other thread) effect the outcome, is it not safe to suggest that more frequent dosing and less volume can produce similar outcomes to less frequent and increased dosages?

Not challenging you, simply asking for your opinion based upon these studies.

What does this mean, "more frequent dosing and less volume"?

Your post seems to use the term volume separate/same from dosing when volume matters none. Dose and Frequency matter. It is confusing. The study I posted provides good examples of dose response curves. It seems you are asking is 500 IU ED the same as 1000 IU EOD. I am unsure. Provide an example with numbers.

 

[Northern Nutrition]

Volume and frequency = "dose and dose interval". Therefore; volume is how much hCG is used and frequency is how often the hCG is administered.

And yes, that's what im asking. Do YOU feel that the volume and frequency can be manipulated to achieve similar results? In other words, can the results of 1500iu E4D be achieved with a higher frequency and lower volume, in your opinion based on the above study and your previous work?

 

[Michael Scally MD]

Volume and frequency = "dose and dose interval". Therefore; volume is how much hCG is used and frequency is how often the hCG is administered.

And yes, that's what im asking. Do YOU feel that the volume and frequency can be manipulated to achieve similar results? In other words, can the results of 1500iu E4D be achieved with a higher frequency and lower volume, in your opinion based on the above study and your previous work?

You really should stay away from the term volume. Stick to Dose & Frequency. That's it. And, the answer will depend upon what you are proposing since too low a dose will do nothing. I have seen where some on TRT are using 100 IU ED. That is a waste.