OK- so how can one be "secondary" and hcg apparently not work?
- 08-16-2007, 05:38 PM
OK- so how can one be "secondary" and hcg apparently not work?
I've posted this here in my journal, but since I hardly expect everyone to read it and think this subject may have broader appeal I'm making it a thread as well.
Upon my return from a few days away I saw an envelope from Quest with my 3 week post start of hcg blood work drawn a week ago. Damn--was I ever disappointed. No change whatsoever. T still essentially unchanged at 224. FSH and LH still barely registering (I expected this). Estradiol is still under 32.
Here are the 8/07 results:
Total T: 224 (241-827)
LH: .2 (1.5-9.3)
FSH: .7 (1.6-8.0)
Estradiol: <32 (<52)
Here are some prior blood results for comparison:
Total/free T (test 1: 4/10/07 Lab work for possible clinical trial which I did not do)
Total T 205
Free T% 5.7
Free T 11.6 (5-21)
E2 9.1 (0-35 pg/ml)
FSH 2 (1-15)
LH 2 (2-12)
DHT 10.28 (no range given)
Prolactin 6 (2-18)
RESULTS POST June 2007 CLOMID TEST:
Test. 319 (up from avg of 200)
FSH 2.4 (up from 1.8-2)
LH 5.0 (up from 2)
DHEAS 250 (241-827)
DHT 18 (25-75)
E2 <32 (<52 Dr did NOT ask for sens. test)
Not sure what to think. I had or have all the indicia of being secondary: Low FSH, low LH and low T. How can I be truly secondary and see no change after 3 weeks on hcg? Put simply, WTF?? I am taking 500iu of hcg 3x/week.
After opening the results I feel like I've been kicked in what's left of my balls. Is it possible for a person to be BOTH primary and secondary? How the hell could THAT have happened? Or, perhaps, all the hcg did was raise my E and nothing more. This might be a possibility as clomid DID raise my T by blocking E. Also, the depression which started shortly after starting hcg can be the result of elevated E. Either way, how could clomid show some improvement while hcg did not? I really have no idea and could use some input.
- 08-16-2007, 05:57 PM
Dr John has wrote about this before - "While HCG, as sole TRT, is still considered treatment of choice for hypogonadotrophic hypogonadism by many , my experience is that it just does not bring the same subjective benefits as pure testosterone delivery systems do—even when similar serum androgen levels are produced from comparable baseline values. However, supplementing the more “traditional” TRT of transdermal, or injected, testosterone with HCG stabilizes serum levels, opposes testicular atrophy, helps rebalance expression of other hormones, and brings reports of greatly increased sense of well-being and libido. My patients absolutely love it"
I do not buy into diagnoses of being "primary, secondary, bla bla bla bla". More often than not, we have so much complicated process to contend with, trying to treat someone based on being "primary" or "secondary" just doesn't work. Some are partially both. Some are estrogen dominant, or cortisol dominant, or both along with primary/secondary issues.
It is this issues why exogenous T MUST be implemented.
08-16-2007, 05:57 PM
08-16-2007, 06:02 PM
I edited the post to include the ncg regime, but here it is again:
08-16-2007, 06:11 PM
08-16-2007, 06:12 PM
Dr John believes, and given his caseload of patients to back himself upon, I agree, that " I recommended 250IU of HCG twice per week for all TRT patients"
That is 500Iu per week. You are taking three times that dose. It is apparent that taking more hcG to make up for a lack of T will not work.
Your baseline T production is just not up to par and exogenous T must be administered.
I don't thin it is an issue of hcG conversion to estrogen. hcG in itself does not aromatize into estrogen. it is a rise in T that aromitzes into E, and that rise in T can come from hcG, but looking at your BW it is painfully aware that this is not the case. It looks to me like it is a simple matter of you not having enough T running threw your blood.
08-16-2007, 11:38 PM
I was also an apparent classic case of secondary. Low LH at around 4 while T untreated was as low as 98 on diagnosis. However HCG did not fully work for me. My case is muddied though because I was on androgel for 4 years before trying HCG and may have had irreversable testicular atrophy. Still Phil on this board was on T replacement for decades and was able to get great results form HCG right away. I have a theory I have not discussed with Dr S yet on this. The theory is I was originally primary. My pituitary made up for this by pumping out massive amounts of LH to keep my T where it should be. Eventually the pituitary wore out and was unable to produce the LH necessary. This would explain why at diagnosis I would appear to be secondary.....low LH and low T. But in reality the original problem was primary. This would also explain why the clomid test did not work for me and why HCG does not fully work for me. At this point I had two problems. The original one of being primary....the second one being my pituitary was unable to produce sufficient levels of LH. Clomid causes the hypothalmus to send more GnRH to the pituitary but if the pituitary is now broken it will not respond to it. At the same time the testicles will not respond normally to HCG because they are also not working properly.
Now I am on HCG and while I can get my T up somewhat on HCG I can not get it up to normal....at least not on 500 iu every day. The best I could do on HCG alone is 300 total T. It all fits but I don't know if there is any truth to it....its just a theory.
08-17-2007, 01:13 AM
Many men have found that HCG + Test is a good therapy, but there are many guys on HCG alone that are doing just fine. Ask Phil about it, remember that every guy is different, and don't completely ignore Dr Shippen's years of clinical experience using HCG alone.
Also don't forget the boards are mostly made up of guys who are not completely happy with TRT. This is sad, but unfortunately true. I've been on the boards a long time and it is very common that once someone gets tuned up, they're gone. You don't hear about those guys any more since they are often busy not worrying about TRT any more. I've been guilty of it when times have been good and have made a promise to myself to stick around regardless.
My 2 cents...
anyman: Keep us posted as to what Dr Shippen wants to do next.
08-17-2007, 01:15 AM
My T on just hcg dropped to an all time low but my sperm count more than doubled...figure that one out.
08-17-2007, 10:42 AM
For SOLO therapy, 500iu 3x a week is not that overly high. Perhaps you would do better with 250iu ED or 300iu ED. But, with the almost ZERO change, it does look like HCG is not enough for you. Too bad, for me it seems to be doing at least SOMETHING positive.
But perhaps theirs underlying conditions not being addressed? Thyroid, adrenals? I know that without addressing those my T, even on adrogel and at 1000 still had ED and all the low t symptoms.
08-17-2007, 12:40 PM
[I know that without addressing those my T, even on adrogel and at 1000 still had ED and all the low t symptoms.[/COLOR][/COLOR][/COLOR][/QUOTE]
What are the specific blood tests one should get for adrenals?
08-17-2007, 02:02 PM
There is some science behind this, the pituitary becomming worn out because of excess LH production. Check this out.
08-17-2007, 02:07 PM
I did not know till yesterday that one of my favorite authors, Auguston Burrows, author of "Dry" and "Running with Scissors" is also on HRT(transdermal Test FYI ) He wrote all about it and his experience in the latest issue, september, of Details magazine. Pretty cool article. Its obvious that he isn't is up to par on this stuff as we are, but still pretty cool to read. He wrote about past steroid use as being reason, but anyone who has ever read "Dry" and knows a thing or two will tell you that his alcohol use was really the culprit that did him in.
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