primary or secondary? not sure....

[akiravp82]

I'm going to break a long story short, basicly my doc says im primary and wouldent prescribe me HCG saying it would not help, a buddy of mine had some extra HCG laying around so i decided to experiment with it , doing 500iu three times a week ( mon,wed,fri) two weeks in my morning erections have resumed, and i feel a little more energy throughout the day but my testicles are still small and havent gotten bigger, anyways my question is, is there a chance maybe i am secondary afterall and my doc made a wrong diagnoice? or will HCG give good results to anyone taking it? i should be getting a new set of labs soon hopefully (money issue) the last time i got tests done was about 3 months ago 9am in the morning here are the results:

total testosterone: 368 ( range 357-827)

estrodial 25 pg/ml

dht: 28 ng/dl

LH: 3.87

FSH: 2.5

 

[Philec48]

LSH at no more than 3.87 with your T at 368 suggests you might be secondary, but you may also have some primary going on, too.

From what I've read, there are a few men that look primary, who have LH in upper normal range, that respond well to HCG. This suggests possibly there is some autoimmune issue with their own LH.

Two weeks is not enough time on HCG to grow your testicles back.

 

[pmgamer18]

Wow Dr.'s are still in the dark about this I went 23 yrs being told I am Primary with levels of T at 120 with levels like yours for LH and FSH. Five yrs ago Dr. John sent me this post to help me get my Dr. to let me try HCG. Here is a copy of the post.
====================================
He probably feels that since you suffer primary hypogonadism (I am guessing) there is no use in adding HCG to your protocol. There are several reasons why this is not so. First, you have not lost all Leydig cells, so any HCG you take will stimulate those who still function to produce endogenous testosterone.

This will support testicular size. We should not ignore this aesthetic consideration.

Next, if he reads my work, he will learn that HPTA-suppressed (as all TRT patients are to some extent) also suffer decreased pregenenolone levels, which is the first step after CHOL in all three hormonal pathways which begin with CHOL. HCG increases pregnenolone production, and therefore restores a more natural balance of our hormones.

Next, nearly all TRT patients who add in HCG to their regimens report an increased sense of well-being and also libido. These are genuine quality of life issues.

Finally, I just instinctively do not want all those LH receptors (including those we have yet to discover and appreciate) unstimulated.
-----------------------------------------------------------------
After going on HCG doing 500 IU's 3x's a week with my T shots my levels doubled after the 15 shot of HCG this told us I am not Primary but I am Secondary my testis were the size of small grapes and in a about 4 months the come back up to there normal size. You can read my story at this link.
http://forums.realthyroidhelp.com/viewtopic.php?f=5&t=9239
I now treat all the hormones that were low and even the ones low normal now I feel better it was to late for my heart the low GH levels did it in I had bypass sugary and now take HGH and doing fine.

 

[akiravp82]

thanks for the response guys, thats intresting i thought that testicles come back in size in a few weeks time?, so it might even take a few months? problem is im running out of HCG and i dont understand why theres so many doctors in this field that dont know know what there doing.... , my last endo i saw i told him about HCG hes response was "uhmmm isnt that for female pregnancy or something?" after i told him what it can do for me he laughed at me and said "look kid i got other patients waiting outside so ill see you later" anyways im thinking i might me a combo of secondary and primary (if that even exits) since 500iu EOD is making a small difference but not to the point where i could use it as TRT, or maybe i need to up the dosage? i remember one guy around here was injecting 8,000iu-10,000iu weekly as hes TRT and he was doing fine, i wonder if i would be a good responder to that dosage? dammit i wish i knew of a doc who would prescribe HCG and that kind of dosage.

 

[Philec48]

You don't want to do 8 to 10k iu of HCG weekly for very long, as you can permanently burn out your receptors. Also, that kind of dose will up your E2 higher than you want it to go. No one should take more than 500iu in one injection. If that's not enough to doing the trick, then adding more is not the answer. You would then need to add in T.

Most docs are down on what they are not up on. He doesn't know about HCG protocols for TRT, so in order to hide his ignorance, he just tells you to get lost.

Tell us where you're at, and some here may be able to suggest some good docs nearby you.

 

[akiravp82]

I live in northridge California , your saying that 8 to 10k a week is to much HCG? i thought some people take that kind of dosage weekly as there main TRT? maybe i misunderstood , so how long on HCG would you say till the boys start growing back?

 

[Philec48]

Yep, that's too much. I know for me, I don't want to risk burning out my leydig cell's receptors. On normal dose HCG, give it a couple of months or so to start seeing some regrowth.

FSH makes leydig cells more responsive to LH by increasing the number of LH receptors.
Some TRT docs may be willing to prescribe one of the analogs of FSH if they feel you need it. They are listed below:

Human Menopausal Gonadotropin (HMG) <Brand names: Bravelle; Repronex>
and
Recombinant Human Follicle-Stimulating Hormone (rFSH) <Brand names: Follistim; Gonal-F>

 

[colkurtz_spf]

I'm going to break a long story short, basicly my doc says im primary and wouldent prescribe me HCG saying it would not help, a buddy of mine had some extra HCG laying around so i decided to experiment with it , doing 500iu three times a week ( mon,wed,fri) two weeks in my morning erections have resumed, and i feel a little more energy throughout the day but my testicles are still small and havent gotten bigger, anyways my question is, is there a chance maybe i am secondary afterall and my doc made a wrong diagnoice? or will HCG give good results to anyone taking it? i should be getting a new set of labs soon hopefully (money issue) the last time i got tests done was about 3 months ago 9am in the morning here are the results:

total testosterone: 368 ( range 357-827)

estrodial 25 pg/ml

dht: 28 ng/dl

LH: 3.87

FSH: 2.5

My LH baseline is 3.9. I'm secondary and a strong responder to HCG.

 

[RavensFan2k3]

Yep, that's too much. I know for me, I don't want to risk burning out my leydig cell's receptors. On normal dose HCG, give it a couple of months or so to start seeing some regrowth.

FSH makes leydig cells more responsive to LH by increasing the number of LH receptors.
Some TRT docs may be willing to prescribe one of the analogs of FSH if they feel you need it. They are listed below:

Human Menopausal Gonadotropin (HMG) <Brand names: Bravelle; Repronex>
and
Recombinant Human Follicle-Stimulating Hormone (rFSH) <Brand names: Follistim; Gonal-F>

This is very interesting stuff. What if ones LH is mid to upper range consistantly, but their FSH is ABOVE the range consistantly, and total test is consistantly aroun 300? Could this mean the testes(sertoli cells) are desensitized to FSH? Keep in mind the testicles have atrophied.

 

[akiravp82]

My LH baseline is 3.9. I'm secondary and a strong responder to HCG.

I beleive you were the one here doing 10,000iu a month right? how is that working out for you? i wish i could try this but im thinking it would probly be almost impossible to find a doctor who would prescribe that kind of dosage

 

[Philec48]

If LH and FSH are consistently upper range with total T at 300, that would seem to suggest primary hypo, but I don't know what mechanism that involves, whether the cells are desensitized, burned-out, or necrotic.

 

[RavensFan2k3]

If LH and FSH are consistently upper range with total T at 300, that would seem to suggest primary hypo, but I don't know what mechanism that involves, whether the cells are desensitized, burned-out, or necrotic.

if the cells(sertoli and leydig) are desensitized, is it possible to increase their sensitivity back to normal? what would cause them to be burned-out or necrotic?

 

[pmgamer18]

Yes I have seen it done just stop the HCG for a time and don't go back on higher levels then 500 IU's at a time.

if the cells(sertoli and leydig) are desensitized, is it possible to increase their sensitivity back to normal?

 

[RavensFan2k3]

Yes I have seen it done just stop the HCG for a time and don't go back on higher levels then 500 IU's at a time.

so HCG overuse is the only cause of desensitized leydig and sertoli cells? what if I have never used HCG before? what are all of the causs of desensitized testes? and what can cause burned out or necrotic leydig and sertoli cells?

 

[pmgamer18]

I know you can desensitized your testis using huge dose's of HCG never heard of anything other then this doing this. Unless your Primary this means your Testis don't work a lot of things can do this your end up with low levels of T and high levels of LH and FSH to be called Primary.

 

[Philec48]

There are a number of causes of testicular dysfunction, such as nutritional, genetic, lifestyle, aging, disease processes, etc...

You may want to look into getting your thyroid and adrenals checked out. Also see if you have sleep apnea, as the reduced oxygen at night will lower testosterone.

Also get your serum zinc and vitamin D (25-hydroxy) checked.

 

[living2die]

Hey pmgamer, how long would it take to become re-sensitized to HCG?

Yes I have seen it done just stop the HCG for a time and don't go back on higher levels then 500 IU's at a time.

 

[pmgamer18]

It's a trial and error thing stop using it for 90 days do labs then try it again. See if your T levels hold up and show a higher level on your labs.

 

[living2die]

Would it be ok to take a low dose AI throughout the period when I would be abstaining from HCG use ?

It's a trial and error thing stop using it for 90 days do labs then try it again. See if your T levels hold up and show a higher level on your labs.

 

[pmgamer18]

Yes very low unless your on TRT if not cut back on it to .25 mgs every 3 days if you lose your night time and morning wood your going to low stop taking it until wood comes back then go back on it but do it every 4 days.

Would it be ok to take a low dose AI throughout the period when I would be abstaining from HCG use ?

 

[living2die]

I know that we at DR. J's board advocate very low dose arimidex, and try to focus on eliminating the use of an AI by tweaking doses to reduce on estradiol. For some of us, an AI is still warranted. I am glad that Dr. J advocates less than <1mg PW for his patients, if any AI at all. I was checking up on studies of arimidex in treating hypogonadism, and in some patients, they were dolling out .5 - 1mg PD ! You would have thought that their estradiol levels would have fallen to nothing, but they actually hit the sweet spot that we aim for in HRT. Here is a graph of the dosages, and the link following the link below is the study itself. I am just posting these links and studies for amusement, I still don't want to exceed 1mg PW of arimidex in this case for clear reasons that less is more in this case.

http://jcem.endojournals.org/cgi/content/full/85/7/2370

Yes very low unless your on TRT if not cut back on it to .25 mgs every 3 days if you lose your night time and morning wood your going to low stop taking it until wood comes back then go back on it but do it every 4 days.

 

[colkurtz_spf]

I know you can desensitized your testis using huge dose's of HCG never heard of anything other then this doing this. Unless your Primary this means your Testis don't work a lot of things can do this your end up with low levels of T and high levels of LH and FSH to be called Primary.

How do you know this? I've been doing large doses by your standards for over four years and respond very well. The study I posted, way back when showed a relationship between sensitivity and frequency. Apparently HCG receptors need to clear. I inject no more than twice per week. I used between 2000 and 10,000 IUs per shot for the first two years. Now I respond well to 750. How do you explain that?

 

[pmgamer18]

You have some dam strong testis that all I can think of Hell I know men doing that much became Primary all of a sudden here levels fell off and they had to go on Test C to get them back up they were Seconday with a Pituitary Problem I helped a lot of people with this problem at STTM's web site when the forums were up. This one poor guy was seeing a Nut Job for a Dr. and he had him doing huge amount of HCG after a time his Testis stopped working never came back.

You can post about this at Dr. John's forum he says never do more the 500 IU's in a day. How do you keep your Estradiol levels from shooting way up. Mine go nuts doing 400 IU's.
http://www.**************.com/forum/private.php

 

[pmgamer18]

I need to find a better way to keep my E2 levels down I have been needing .5 mgs of Arimidex to 1 mgs a day. I think I am suffer from Estradiol Rebound.

I know that we at DR. J's board advocate very low dose arimidex, and try to focus on eliminating the use of an AI by tweaking doses to reduce on estradiol. For some of us, an AI is still warranted. I am glad that Dr. J advocates less than <1mg PW for his patients, if any AI at all. I was checking up on studies of arimidex in treating hypogonadism, and in some patients, they were dolling out .5 - 1mg PD ! You would have thought that their estradiol levels would have fallen to nothing, but they actually hit the sweet spot that we aim for in HRT. Here is a graph of the dosages, and the link following the link below is the study itself. I am just posting these links and studies for amusement, I still don't want to exceed 1mg PW of arimidex in this case for clear reasons that less is more in this case.

http://jcem.endojournals.org/cgi/content/full/85/7/2370

 

[colkurtz_spf]

I don't know that I have strong testes. The doctor I used to see had patients 10 plus years on high doses of HCG. I think the problem your seeing lies in frequecy not volume. I tried frequent injections and experienced a drop with negative sides. Leydig cells need time to clear. I bet those guys you refer to were primary, or near primary from the get go...just a hunch.

You have some dam strong testis that all I can think of Hell I know men doing that much became Primary all of a sudden here levels fell off and they had to go on Test C to get them back up they were Seconday with a Pituitary Problem I helped a lot of people with this problem at STTM's web site when the forums were up. This one poor guy was seeing a Nut Job for a Dr. and he had him doing huge amount of HCG after a time his Testis stopped working never came back.

You can post about this at Dr. John's forum he says never do more the 500 IU's in a day. How do you keep your Estradiol levels from shooting way up. Mine go nuts doing 400 IU's.
http://www.**************.com/forum/private.php

 

[pmgamer18]

I don't know but I can tell you I got some bad Novarel last Nov. and it kicked my Ass big time I never seen my Estradiol take off like this and others on it were saying the same thing. When my Estradiol goes to high I have panic attacks not that the Estradiol causes them but the feelings form being to high sets it off.

My Dr. called Ferring about this he has 8 other men on Novarel and they were having the same problem. Turns out Ferring job out the Novarel to a lab in Canada and they did something wrong making it. I got a new lot # and Exp. date last week and it's fine now. But I still need a lot of Arimidex now to keep my E2 levels down.

Doing that much HCG how did you control your Estradiol levels.

 

[colkurtz_spf]

I've used arimidex at different doses depending on my needs. Until recently I had been using .5mg twice per week with 750 IU HCG injections. My last blood draw showed estradiol at 18, so my doctor has asked me to stop taking for the time being.

I don't know but I can tell you I got some bad Novarel last Nov. and it kicked my Ass big time I never seen my Estradiol take off like this and others on it were saying the same thing. When my Estradiol goes to high I have panic attacks not that the Estradiol causes them but the feelings form being to high sets it off.

My Dr. called Ferring about this he has 8 other men on Novarel and they were having the same problem. Turns out Ferring job out the Novarel to a lab in Canada and they did something wrong making it. I got a new lot # and Exp. date last week and it's fine now. But I still need a lot of Arimidex now to keep my E2 levels down.

Doing that much HCG how did you control your Estradiol levels.

 

[pmgamer18]

That is a good level my SHBG is 20 so I keep my Estradiol at 15 pg/ml as per Dr. John at www.allthingsmale.com he says the lower your SHBG the lower you can keep your Estradiol levels. I gage my Estradiol levels by my night time and morning wood. If I go to low I lose my wood Virgra will not get it up. So when this happens I stop the arimidex until my night time and morning wood comes back that day I go back on it but take less. Most of the time I do good at .25 mgs every 2 to 3 days.