I have been on TRT for about 2 years; I was formally diagnosed with hypogonadism. I take T CYP weekly, HCG weekly (since the beginning) and just a little arimidex.
I just began seeing a new endocrinologist and, because I have always had the best response to HCG, he wants to try HCG monotherapy.
First, he wants me to go off of everything all together. He wants to see what my baseline levels are for a couple of reasons. My LH was normal with a total T in the mid 300s (this lab's range started at 350, so I was definitely below normal range) and he said he would have expected LH to be higher in the face of lower T. Obviously he suspects secondary, or he said possibly hybrid idiopathic hypogonadism.
This is because I had a testicle which didn't descend until later on and has always been smaller than the other.
My primary doctor was great but the endo said he wish he had done a clomid stim and a couple other things, which is why he wanted to see me at baseline. He also wants to do a pituitary MRI and a DEXA scan to make sure the arimidex isn't harming my bones.
Bottom line is he is caring and forward thinking, which is not what I expected from an endocrinologist based on what I've read around the forums. Maybe it's because I was below normal range. Anyways...
He acknowledged that I could likely feel a little crash in energy levels coming off the TRT, though he said he expected the HCG to have maintained some baseline endogenous function.
He wants me to come off TRT and stay off for a number of months (up to 6) during which time he wants to perform the baseline testing, clomid stim, etc... He wants to make sure, with repeated am testing that my levels were truly low.
If my baseline remains low and I am symptomatic, he wants to try HCG mono, adding arimidex only if necessary. His opinion was that if the HCG dose simply restored me to normal T levels (for me) I would likely not have a problem with excess aromatization, which was probably a function of being on a T level too high for me now (I'm 850ish at trough). But he said some patients have a proportionately higher response to have higher-ish E on HCG, so he was not against it if necessary.
Interestingly, he also said he had no problem with long term HCG use and said one of the reasons they used to not do it was because of cost. It was nice to hear that from an endo.
He said HCG can restore a much more normal testosterone rhythm in some men but if I was unresponsive, he would have no problem putting me back on IM at levels which made me feel well.
All in all, I'm grateful to have this guy.
Sorry to be long winded, but I asked him about using clomid or something like that (PCT) to make the crash less. He said if I could provide him with support of this, he might consider it but obviously would consider me "enhanced" and it would be 6 months-ish from the end of ANY drug for testing.
So here's the bottom line...1. What does everybody think of the above, and 2. Any recommendations for "PCT"/restart.