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Long term use of HCG safe?

rick055

Active member
Hello, all, I am new on the board and have to say this is by far and away the most mature board on this subject I have seen, especially with the contributions of Dr. John with whom I am planning on arranging a consultation through my PCP.

That said, I am curios about the use of HCG as an adjunct therapy to TRT.

I have heard many different schools of thought ranging from doing it once (or more) a week to a month long cycle every few months and in lieu of testosterone during that period.

My total T at age 36 is only 425 and I'm symptomatic) I want to make sure I understand the nuances, as I have heard that HCG can cause cancer (???) and I believe my congenital anamoly increases my chances for same.

Also, if anyone knows, is the long term use of arimidex safe? Are these two adjunct therapies commonly used long term for HRT?

Thanks in advance!
 
rick055 said:
Hello, all, I am new on the board and have to say this is by far and away the most mature board on this subject I have seen, especially with the contributions of Dr. John with whom I am planning on arranging a consultation through my PCP.

That said, I am curios about the use of HCG as an adjunct therapy to TRT.

I have heard many different schools of thought ranging from doing it once (or more) a week to a month long cycle every few months and in lieu of testosterone during that period.

Being that this may be a lifelong thing for me (had a surgically corrected undescended testicle at age 10, my total T at age 36 is only 425 and I'm symptomatic) I want to make sure I understand the nuances, as I have heard that HCG can cause cancer (???) and I believe my congenital anamoly increases my chances for same.

Also, if anyone knows, is the long term use of arimidex safe? Are these two adjunct therapies commonly used long term for HRT?

Thanks in advance!
Click to expand...

Hard to say, I think both HCG and Arimidex are safe when used in doses mostly used for TRT.

Human Growth Hormone, HGH,
I have cancer, liposarcoma.
Some cancers are promoted by HGH, my cancer is within that group, I will not use HGH.

All this is rather cutting edge, hard to find definitive information.

Lately there was a thread on Sermorelin.

Invalid Link Removed

Sermorelin induces body to produce its own HGH.

It is going to be tougher and tougher to figure out.
==============================================

With your TotalT=425 you have little choice, you have to use testosterone.
You do have certain amount of choice about HCG.
If you do not care about preserwing fertility, do not use HCG, your testis will shrink but that is cosmetics at this point.

Make sure that you get more thorough test than just testosterone, usually people who have low T shortly find out about other problems that they have.

Start with good blood test. Use mine list here, post #44.
You may want to peruse the whole thread.
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html
----------------------------------------------------------
Often people start on Tgels, creams etc. Transdermals do not work for certain group of people. For some they work.
Try to spend as liitle time as possible on transdermals.
If you find they do not work for you go ASAP for injections.
Make sure they are SubQ 31ga needles, rather than big nails.
Here usualy doc may want to give you only smal dose of Testosterone, no HCG and se if that would work.
After your testis are shrunk, they make attempt at reviwing them, give you script for HCG.

I wish I could have started with higher dose of T and HCG righ away.

On my thread:
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html
I figured out how to get to proper injected T-dose quicker.
You need to have SHBG value to figure that out.

When time comes I can help you figure out your initial dose.

Make sure you do long blood test, will save you tons of grief.
 
"Sermorelin induces body to produce its own HGH.

It is going to be tougher and tougher to figure out"

I wonder if this will make you exempt JansZ, and safe to use.

Your total QOL will go up drastically with a proper IGF-1 level. This is as big of a piece to the puzzle as T and E.
 
JanSz said:
With your TotalT=425 you have little choice, you have to use testosterone.
Click to expand...



Here's what I had then, I am calling Dr. Crisler today:

TESTOSTERONE, TOTAL: 455 (400 - 1080 ng/dl)
TESTOSTERONE, FREE: 111.3 (47.0 - 244 pg/ml)
TESTOSTERONE, % FREE: 2.4 (1.6 - 2.9%)
SHBG 18 (11-80 nmol/L)
TSH 3.12 (.35 - 5.50 uIU/mL)
HGB A1C 5.5 (0 - 5.9%)

CHOLESTEROL 253**
TRIGLYCERIDES 255**
HDL 40
LDL 162

PSA .74 (0 - 4.00 ng/mL)
PSA, FREE 0.31 ng/mL
 
rick055 said:
And I think even that may be exaggerated as when I had the labs drawn I was on finasteride, and as I understand it, finasteride can increase your total test.

Here's what I had then, I am calling Dr. Crisler today:

TESTOSTERONE, TOTAL: 455 (400 - 1080 ng/dl)
TESTOSTERONE, FREE: 111.3 (47.0 - 244 pg/ml)
TESTOSTERONE, % FREE: 2.4 (1.6 - 2.9%)
SHBG 18 (11-80 nmol/L)
TSH 3.12 (.35 - 5.50 uIU/mL)
HGB A1C 5.5 (0 - 5.9%)

CHOLESTEROL 253**
TRIGLYCERIDES 255**
HDL 40
LDL 162

PSA .74 (0 - 4.00 ng/mL)
PSA, FREE 0.31 ng/mL
Click to expand...

Some people (small %%%) get really screwed by finasteride.
Wonder what makes the difference.
I used to use Proscar and Avodart.
When I stopped Procar or Avodart, the DHT went up, so I think I am not in that group.
 
JanSz said:
Some people (small %%%) get really screwed by finasteride.
Wonder what makes the difference.
I used to use Proscar and Avodart.
When I stopped Procar or Avodart, the DHT went up, so I think I am not in that group.
Click to expand...

Possibly people with moderate to low DHT in first place.

Plenty like this.

DHT gets driven into ground. All sorts of issue arise.
 
Jansz: You stated above that HCG causes your testes to shrink and hampers fertility. Is that right? I thought exogenous Test would cause this and HCG (LH) would keep the testes going throughout. In fact, one doctor recommended androgel for low test coupled with repronex (FSH/LH) to keep fertility high. An expensive propostion.
 
Pace2 said:
Jansz: You stated above that HCG causes your testes to shrink and hampers fertility. Is that right? I thought exogenous Test would cause this and HCG (LH) would keep the testes going throughout. In fact, one doctor recommended androgel for low test coupled with repronex (FSH/LH) to keep fertility high. An expensive propostion.
Click to expand...

Hopefully I did not say that (but I am 67yo so there is always possibility of early senility).
The other possibility may be that my glass with Merlot was little to big, then may be your glass was big.

When making such statements it is good to first provide quote and link where that quote came from.
----------------------------------------

When I was on Androgel only, for few years, my testis shrunk to nothing, as expected.

I started HCG in feb 2007 and within a month size of my testis came back.

I started HCG E2D 250iu in Feb 2007.
Since 6/19/2007 I am on 500iu E3D, possibly two days free of HCG makes my testis fluctuate hardness wise. They are newer as hard as they used to be in my hey days.

But the pines works all right, so I do not worry too much.
 
Pace2 said:
Jansz: You stated above that HCG causes your testes to shrink and hampers fertility. Is that right? I thought exogenous Test would cause this and HCG (LH) would keep the testes going throughout. In fact, one doctor recommended androgel for low test coupled with repronex (FSH/LH) to keep fertility high. An expensive propostion.
Click to expand...
JanSz said:
You do have certain amount of choice about HCG.
If you do not care about preserwing fertility, do not use HCG, your testis will shrink but that is cosmetics at this point.
Click to expand...
The exogenous test causes shut down (reduced LH)and shrinkage. The HCG stimulates LH and promotes testies function. This may increase size and improve fertility.

I think that is what he said. :)

I do not use HCG as I have no need for fertility and can live with some testie atrophy, but I have seen some increase in size and ejaculate volume using USPLabs PowerFULL. It proported to raises test by stimulating LH. It has made an improvement in mood and sense of well being.
 
B5150 said:
, but I have seen some increase in size and ejaculate volume using USPLabs PowerFULL. It proported to raises test by stimulating LH. It has made an improvement in mood and sense of well being.
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Elaborate further. What ingredients are in product?

Anything that stimulaltes a release of LH will prevent testicular shutdown.

There are a few products that come to mind.

One is tribulus, Another is resveratrol. I was always under the impression that neither is strong enought to equal hcG.

Another question - Are you fertile on T without hcg? This would be a nice side bonus to many if one became infertile.
 
In the case of secondary hypogonadism, if fertility on a long-term basis is desired but on a short-term basis it is not, is it better to run to run hCg while on test or not?
 
I cannot say that it equates to HCG but anecdotally I am responding with improved testie size, scrotal volume and ejaculate volume.

My LH was diminshed weeks after beginning TRT. I have not since had any bloodwork for LH with TRT or PowerFULL.

I was fertile before TRT and have no idea after. I also have a vasectomy.

Invalid Link Removed
 
my one friend said long term use of HCG can make you look like a cavemen, like big head and changes the way you look in a bad way
 
engival said:
my one friend said long term use of HCG can make you look like a cavemen, like big head and changes the way you look in a bad way
Click to expand...

I bet hes thinking HGH. Its called acromegaly and judging from pics of bodybuilders who use it and pics of people with the disorder, it must require ridiculous doses of the stuff.
 
So the general consensus is that, with TRT it's better to use HcG continually throughout the treatment as opposed to sporadically?

Why? Can anyone point me to some articles/med journals?
 
rick055 said:
So the general consensus is that, with TRT it's better to use HcG continually throughout the treatment as opposed to sporadically?

Why? Can anyone point me to some articles/med journals?
Click to expand...

The first thing about LH cells in the body and places we don't know about are way we need to use HCG be it your Primary or Secondary. Doing TRT shuts down the LH messages from your Pituitary this means any LH receptors including those we do not know about yet go unstimulated. This is way a lot of men get a feeling of well being when they add HCG to there TRT.

I just can't see not doing HCG it to me is not about the size of my testis it is about LH receptors not working without HCG.
 
plymouth city said:
Elaborate further. What ingredients are in product?

Anything that stimulaltes a release of LH will prevent testicular shutdown.

There are a few products that come to mind.

One is tribulus, Another is resveratrol. I was always under the impression that neither is strong enought to equal hcG.

Another question - Are you fertile on T without hcg? This would be a nice side bonus to many if one became infertile.
Click to expand...
B5150 said:
Invalid Link Removed
Click to expand...
Here is USPLAbs' statement on the active:
USPLabs said:
There are 2 indian studies that suggest elevated testosterone on both herbs that are not published, and we came up with the equivalent of 100mgs which is a very low number.

by stimulating LH is the proposed mechanism.

The PowerFULL Saponingens are indepedantly anabolic and 1-c elevates HGH.
Click to expand...
 
Phil, that is an excellent point about HCG stimulating other LH receptors. Never thought about that but it makes sense.

To answer the original question, most of us are using HCG all the time while on T replacement. We have not found any credible evidence that I know about that it may cause cancer or any other problems. Jsut keep your dose low. The lower you can get away with the better because if you dose too high your testicles will eventually become desensitized to it. The max dose is 500 iu per day but most are doing a lot less than that. Dr. Shippen started me on 300 iu three times a week. If you start there you can adjust your dose up or down depending on lab results.
 
farmerjohn said:
Phil, that is an excellent point about HCG stimulating other LH receptors. Never thought about that but it makes sense.

To answer the original question, most of us are using HCG all the time while on T replacement. We have not found any credible evidence that I know about that it may cause cancer or any other problems. Jsut keep your dose low. The lower you can get away with the better because if you dose too high your testicles will eventually become desensitized to it. The max dose is 500 iu per day but most are doing a lot less than that. Dr. Shippen started me on 300 iu three times a week. If you start there you can adjust your dose up or down depending on lab results.
Click to expand...

"The max dose is 500 iu per day"

That would be a max 500iu /day, every day.

That is how I understood dr John's
Invalid Link Removed

I am doing 500iu E3D
so my hcg shots coincide with my T shots, for convenience.

Previusly, until june 19/07 I was on E2D 250iu

I see fluctuations in consistency/hardness of my testicles now.
The E2D was better for testicles but since I do not worry about fertility and my testicles are not producing T (I think), I let the convinience part decide on my schedule.
 
farmerjohn said:
Phil, that is an excellent point about HCG stimulating other LH receptors. Never thought about that but it makes sense.

To answer the original question, most of us are using HCG all the time while on T replacement. We have not found any credible evidence that I know about that it may cause cancer or any other problems. Jsut keep your dose low. The lower you can get away with the better because if you dose too high your testicles will eventually become desensitized to it. The max dose is 500 iu per day but most are doing a lot less than that. Dr. Shippen started me on 300 iu three times a week. If you start there you can adjust your dose up or down depending on lab results.
Click to expand...

Phil: I agree, that is an excellent point about the HcG. I had heretofore only thought about it in the context of what it was doing to maintain testicular function.

FarmerJohn: Thanks for an answer. It's been a long road just in getting to the testosterone question. Now I find out there's about a dozen more I need to consider!!

Did the HcG do anything for you other than help with testicular function? i.e. did it improve your mood?
 
Let me ask another "subquestion":

If one wanted to try to increase his own natural test production in such a way as to not have to be on exogenous testosterone for the rest of his life, is there a protocol for that? Like doing a course of HcG along with HGH to try to stimulate/grow Leydig cells? What would that look like?
 
JanSz said:
"I see fluctuations in consistency/hardness of my testicles now.
The E2D was better for testicles but since I do not worry about fertility and my testicles are not producing T (I think), I let the convinience part decide on my schedule.
Click to expand...

Given testicals have responded(increase in size) I would say that they must be producing some T.

If hcG was inneffective in such situation we would see no response in teste size.

Something is going on, albiet we do not know how much of a t response.

Dr John has pointed out various times about LH signals being scattered throughout body. It is this rationale why hcG is more important than hmG. hmG is basically artifical FHS. FSH is only within testicals, so rationale is that it has little effect in grand scheme of things outside of fertility.
 
B5150 said:
I cannot say that it equates to HCG but anecdotally I am responding with improved testie size, scrotal volume and ejaculate volume.

My LH was diminshed weeks after beginning TRT. I have not since had any bloodwork for LH with TRT or PowerFULL.

I was fertile before TRT and have no idea after. I also have a vasectomy.

Invalid Link Removed
Click to expand...

I am in almost the same boat as you. I too have had a vasectomy and don't have too much use for my nuts now that I am on TRT other than cosmetic reasons. I hear ya about the Powerfull (I buy the bulk version), although I haven't used it since I have been on TRT. I was thinking about trying LJ100 since it is claimed to be the "Herbal HCG"
Invalid Link Removed
 
plymouth city said:
Given testicals have responded(increase in size) I would say that they must be producing some T.

If hcG was inneffective in such situation we would see no response in teste size.

Something is going on, albiet we do not know how much of a t response.

Dr John has pointed out various times about LH signals being scattered throughout body. It is this rationale why hcG is more important than hmG. hmG is basically artifical FHS. FSH is only within testicals, so rationale is that it has little effect in grand scheme of things outside of fertility.
Click to expand...

Yep the little guys are starting to grow again feels SO GOOD. Only thing I miss is that makes the other look smaller :icon_lol: OH well can not have everything can we.

250ius hcg every 3 rd day works good..now we just have to wait to see it does with my e2 SIGH !!
I do notice my muscle getting fuller and harder looking could this be the e2 coming in check from being so low ?

Can any one find credible evidence that fish oils lower shbg ?
 
When I see my doc for my first follow up next month I am going to bring him Dr. Johns papers about HCG. I know Dr's. in general hate it when you do that, but I don't feel like he is helping me because he doesn't even know what effects E2 have on the male body. When I asked him about it he gave me the "deer in the headlights" look. I just can't switch Endos because I am in the military and it took a year to just get this far. So, I want this guy to help me, but I don't want to P*** him off because he is the only chance that I got and at least he has me on test cyp. I can get the Arimidex myself (I got some on the way just in case), the HCG is not necessary, but it would be nice.
 
does any1 have solid proof or even a study indicating that overdoing hcg can damage Leydig cells in humans? Im gonna need something to show my doc if indeed its true.

typical protocall here are hcg 3x1500iu / week and he says he has guys who been doing this for years. Guess they use it as sole trt.
 
Rick,
The HCG did not effect me in other ways that I am aware of. That said, I did not have any depression problems before HCG. I guess I was cranky while on low T but I was on androgel for 4 years before I switched to HCG so I can't say if it helped my mood I guess. I know many men do have depression and other emotional issues when T is very low so your question is very valid but for me it was not an issue. Also, I should say that even though HCG by itself does not work for me, I feel best on the 4 days a week I take HCG. I take T cyp on Wed and HCG on Sat thru Tue.

Good question also above about any studies on HCG desensitizing leydig cells. I have taken this for gospel since I have read it so many times and Dr Shippen has told me this but I do not know of studies. There may not be any and this may be anecdotal evidence from Dr Shippen and other pioneers in this area. Actually if there were studies to show this I doubt the ASCE guidlines for HCG protocol would call for such high doses as it does.

In any event here is the argument to use with your doctor. You always want to take the least dosage possible of any drug as long as it works for you. Why take any more than you need. In the case of HCG, according to Dr. Shippen, if your dose is too high the result is your E2 rapidly rises while your T only goes up marginally from the extra dose above the optimal level for your particular body.
 
JanSz said:
When I was on Androgel only, for few years, my testis shrunk to nothing, as expected.

I started HCG in feb 2007 and within a month size of my testis came back.

I started HCG E2D 250iu in Feb 2007.
Since 6/19/2007 I am on 500iu E3D, possibly two days free of HCG makes my testis fluctuate hardness wise. They are newer as hard as they used to be in my hey days.

But the pines works all right, so I do not worry too much.
Click to expand...

Can you explain the time frame for shrinkage? How did this effect libido, latency to climax and how did adding HCG change things?
 
Here is my overarching question about TRT and HcG in general:

1. You have low testosterone so you start testosterone therapy.
2. You feel good for a while
3. The added testosterone supresses your HPT axis, causing your body's production to lower.
4. You don't feel so good anymore.

Don't you almost have to use HcG or add more test or something at that point? How does that all work?

Also, has anyone here used Nebido? There's a great article about it Muscular Development this month as a means for TRT in hypogonadal men. It talks about a German study in which men had success and said estradiol levels did not increas much on the drug because it was evenly released or something like that.
 
TiredOldFart said:
Can you explain the time frame for shrinkage? How did this effect libido, latency to climax and how did adding HCG change things?
Click to expand...

I started on 5gram, one packet of Androgel.
When I started my TotalT~300
At first it was very good, then in (I think) in few months it started going downhill.
Also during that time my balls disappeared.
I did not knew about balls at that time so I was not reay payng attention to that.
But it took long time, say six monts for them to be gone.

It took 30 days on HCG to get the balls back.
As far as I can tell, I do not have any sensation, benefits or otherwise from using HCG.

I am using Novarel.
I am using it until it is gone.
I do not see any difference (balls size etc) when I am starting fresh vial or when I am on the end of the vial, in 80 days or so latter.
 
rick055 said:
Here is my overarching question about TRT and HcG in general:

1. You have low testosterone so you start testosterone therapy.
2. You feel good for a while
3. The added testosterone supresses your HPT axis, causing your body's production to lower.
4. You don't feel so good anymore.

Don't you almost have to use HcG or add more test or something at that point? How does that all work?

Also, has anyone here used Nebido? There's a great article about it Muscular Development this month as a means for TRT in hypogonadal men. It talks about a German study in which men had success and said estradiol levels did not increas much on the drug because it was evenly released or something like that.
Click to expand...

Points
1.
2.
3.
4.
are correct
conclusion is not
Correctness or incorrectness is in eye of beholder.

There is always adjustment period.

When ones goal is to reach stable condition ASAP, one should use HCG at the start of therapy
and testosterone shots at the very start. And I am talking about tiny, did I said tiny 5/16" long, needles for both T+hcg shots, not the 1.5" long nails driven into tender flesh that hurt next 2-3 days.

Just looking at those needles one thinks of everything else, gells, tcream, anything but those needles, and forget about frequent injections.

There are always other considerations.

1. one is done with steroid cycles and would like to come back to more normal life

2. newer used steroids, but is hoping that there is a way to make his balls work

3. one likes to know if hi is primary or secondary, like if that would give him some gain or other satisfaction.

4. desires to father child is only valid excuse in my book.
But here doctors unnecessarily put men thru hardship and deppressive state of mind due to low T. One can be on T shots plus HCG and be fertile, when problems arrise add HMG for a year. There is no need to drive testosterone down in mean time. Somebody attempting to be a father needs all the energy he can muster. Fatherhood is big job for the next couple of decades, at least.

5. there are other variants, most notable, uncooperative doctors, or doctors who want to experiment to broaden their expertise, that I can understand, little choice, except stating you goal to doctor and telling him of no desire for much experimentation.
 
nallepuh said:
does any1 have solid proof or even a study indicating that overdoing hcg can damage Leydig cells in humans? Im gonna need something to show my doc if indeed its true.

typical protocall here are hcg 3x1500iu / week and he says he has guys who been doing this for years. Guess they use it as sole trt.
Click to expand...

Dr Johns protocol on hcG, it is a sticky at the top of page.

Your Dr's hcG protocol is stone age and completely backwards
 
JanSz said:
, one should use HCG at the start of therapy
and testosterone shots at the very start.
Click to expand...
JanSz said:
This type of thinking is extremely incorrect.

One should NEVER start HRT right away with hcG.

We need to establish a baseline value on how a individual person will react to exogenous testosterone being administered.

Everyone is different, we simply cannot guess on how a person will react. This is why we start with one thing at a time. The testes will be perfectly fine without hcG for the first month, and you won't necessarily "crash".

Once we get a baseline reading for BW after T has been administered, and we have a feeling how the person has been reacting, especially TT and E2 wise, and we make adjustments in exogenous T and AI, THEN we add hcG. The theory is, and I STRONGLY agree with it, that once T and dose of T being administered, and E and AI stuff is in line, adding hcG won't upset this delicate balance.

If you add in hcG right away at the start of therapy it will throw everything off.

And JansZ you know my feelings on why a person should start with a transdermal first.
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Click to expand...
 
I've got a couple of questions for you, Plymouth:

1. If you think transdermals are the way to go, do you recommend the brand names or a compounded gel? What %age/dose to start?

2. How do I get my PCP to prescribe a compounded product?

3. What about Nebido? Good article in M/D this month. Seems to raise everything gradually, although they were suggesting follow up shots could be at 9 weeks versus 14.
 
rick055 said:
I've got a couple of questions for you, Plymouth:

1. If you think transdermals are the way to go, do you recommend the brand names or a compounded gel? What %age/dose to start?

2. How do I get my PCP to prescribe a compounded product?

3. What about Nebido? Good article in M/D this month. Seems to raise everything gradually, although they were suggesting follow up shots could be at 9 weeks versus 14.
Click to expand...

1. I recommend the compound gel, for two reasons. First, it is cheaper. Second, BECAUSE it is compounded, the very nature of compounding drugs to change variables, it is STRONGER. That means your getting more T in less gel. So we are applying less gel. This is a big advantage.

2. Physicians are sympathetic to their patients monetary issues. I suggest you go the money route. Simply explain to him/her that you can get your T for much cheaper via compouding pharmacy. Find compouding pharmacy in your area via google. Print out page listing prices and show him.

3. My issues with Nebido are the same with all injects - they completely ignore the daily "Pulses" and rythym of natural testosterone production. T is supposed to be highest at beginning of day and drop down at the end of the day for circadian rhythm. For these process, transdermals simply cannot be beat, hands down they are superior, even to nebido
 
plymouth city said:
Rick,
I also recommend everyone start with an average of 5mg of T per day, and adjust from there.
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Plymouth-

OK, the idea of a gel makes sense, I had never heard the circadian rhythm explained before.

My only real issue with the gel heretofore had been the higher relative conversion to DHT reported and my concern about losing hair. (Does anyone know if you can order Dr. John's shampoo without being a full fledged patient or is that a prescription item also?)

My physician is understanding and I have spoken with the local compounding pharmacy (25 minute drive) who has told me they can compound a gel. Specifically, what would I ask my physician to prescribe? i.e. XX grams of XX percent testosterone.

And if I understand you correctly, your opinion is to start with the gel only, retest levels in XXX weeks, then get estrogen in line (arimidex? clomid?), retest again, THEN consider HcG.

Lastly, I have heard about skipping the gel one day a week - what is this for? Is this a rhythm issue also?
 
rick055 said:
Plymouth-

OK, the idea of a gel makes sense, I had never heard the circadian rhythm explained before.

My only real issue with the gel heretofore had been the higher relative conversion to DHT reported and my concern about losing hair. (Does anyone know if you can order Dr. John's shampoo without being a full fledged patient or is that a prescription item also?)

My physician is understanding and I have spoken with the local compounding pharmacy (25 minute drive) who has told me they can compound a gel. Specifically, what would I ask my physician to prescribe? i.e. XX grams of XX percent testosterone.

And if I understand you correctly, your opinion is to start with the gel only, retest levels in XXX weeks, then get estrogen in line (arimidex? clomid?), retest again, THEN consider HcG.

Lastly, I have heard about skipping the gel one day a week - what is this for? Is this a rhythm issue also?
Click to expand...

Check this out - Invalid Link Removed

I have wrote about the DHT issue extensively before. IMO this is way overblown and many are simply reaching for an excuse to shoot for injects. This is false thinking.

Circulating DHT levels and issues such as acne, balding and BPH is not directly coorelated. This is a very complex process. It is involved with FT - DHT conversion via 5 alpha enzyme on skin(acne) scalp(balding and prostate(BPH). Bad estrogen metabolites and aging are at play and increase action of this enzyme that converts FT- DHT via enzyme. DIM + TMG can be used to prevent bad estrogen metabolites at play.

DHT is a very important hormone. As long as levels are kept within range you will be fine.

Pregnenolone is now added in most cutting edge HRT programs like Dr John uses. Pregenelone causes a small rise in progesterone, which helps prevent T to DHT conversion, so with the addition of preg, DHT is kept in check. Pregenelone also fills in metabolic pathways and causes a rise in not just T, but an increase in other androgenic hormones such as the various andros, DHEA and others. Very ingenious.

Shoot for max strength T cream via compounding pharmacy. Testosterone Gel (Compounded) 10%

Start with gel first then restest. The AI of choice now(if needed) is arimidex. It can be pricey but cheaper alternatives are available. PM me. Starting dose is .25mg E3D. Clomid is not needed.

I am not familiar with skipping a day using transdermals yet, this is something I will talk to Dr John about when I see him.
 
Plymouth-

Thanks again, I am thinking of just driving to Michigan for the day as opposed to going through my PCP. As I understand it, I only need to physically make the trip once and it might be easier.

Regardless, I am going to have my PCP run the labwork, as he is open to treatment himself and I can get coverage for it.
 
plymouth city said:
1.

3. My issues with Nebido are the same with all injects - they completely ignore the daily "Pulses" and rythym of natural testosterone production. T is supposed to be highest at beginning of day and drop down at the end of the day for circadian rhythm. For these process, transdermals simply cannot be beat, hands down they are superior, even to nebido
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Is it yr opinon that this slow releasing injection is better than T cyp or other injections since u say "even to nebido" ?
 
plymouth city said:
3. My issues with Nebido are the same with all injects - they completely ignore the daily "Pulses" and rythym of natural testosterone production. T is supposed to be highest at beginning of day and drop down at the end of the day for circadian rhythm. For these process, transdermals simply cannot be beat, hands down they are superior, even to nebido
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Gel aplication is not even close in replication of circadian rhythm.
Replication of circadian rhythm is most likely impossible and its benefits are overrated.

Few people that are on pellets report most happy outcomes.

Vforcer2 at first abbandon pellets due to cost, now he is back on pellets. I think the price is going down.
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My problem with pellets is that they are more or less a cookie cutter method. Last about 3 months.
In that time TotalT level (gradually) drops from about 1200 to 800.
No account for SHBG levels, for some TT on pellets may be too much, for others not enough. Possibly those who are happy require this particular TT levels.
SHBG rises with age, possibly pellets are good for large portion of seniors and younger men with higher SHBG.
 
I do like the idea of the Nebido injections being 8 - 12 weeks apart after the preliminary loading phase.

I wonder how you would incorporate hCG into this. Would it be 100 iu E3D? In the M/D article this month it was noted that hCG was not needed to get test levels to normalize upon cessation, whatever that means.

I think a drawback might be price, though; it's a new, patented drug and they're going to have to make their advertising money back somehow.
 
rick055 said:
I do like the idea of the Nebido injections being 8 - 12 weeks apart after the preliminary loading phase.

I wonder how you would incorporate hCG into this. Would it be 100 iu E3D? In the M/D article this month it was noted that hCG was not needed to get test levels to normalize upon cessation, whatever that means.

I think a drawback might be price, though; it's a new, patented drug and they're going to have to make their advertising money back somehow.
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I think there is a study that says about 110iu/day or even slightly more makes testis produce close to 100% capacity (capacity= whatewer they are able to produce).

Since usually we want to do shots as least as we can,
250iu/E2D is commonly used.

My testis production is nill, to keep their size I use 500iu E3D, that coincides with my E3D T shots.
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If I do one or two shots at the sitting, for me it is same.
So I consider E3D (T+hcg) routine more convenient and beneficial, than

T 1/week plus 2 days of HCG, that is 3 days with shots in a week, infrequent T shots, causing disstress in some.
 
rick055 said:
Plymouth-

Thanks again, I am thinking of just driving to Michigan for the day as opposed to going through my PCP. As I understand it, I only need to physically make the trip once and it might be easier.

Regardless, I am going to have my PCP run the labwork, as he is open to treatment himself and I can get coverage for it.
Click to expand...

That would be best, IMO.

Forget the labwork. The gold standard is to get Urines IMO. Dr John will run that for you.
 
plymouth city said:
. Second, BECAUSE it is compounded, the very nature of compounding drugs to change variables, it is STRONGER. That means your getting more T in less gel. So we are applying less gel. This is a big advantage.
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Not necessarily. It all depends on what concentration the physician prescribes. There is also an upper limit to the concentration. I don't remember what Dr. John said the maximum concentration is, but above that concentration, the T tends to stay on the surface of the skin in a "frost,'' rather than being absorbed.
 
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