HCG only vs. TRT only vs. TRT/HCG Combo

[DavidZ]

Originally Posted by SWALE

No, just T does not do the same things. They (T from HCG and T from TRT) are completely different.

Why? Isn't T just T?

If anything, I would think the body would prefer the T that it makes to exogenous T.

Originally Posted by SWALE

I have achieved the same serum androgen levels in men with test cyp or test gel they had on just HCG, and all report they felt better on the testosterone.

Do you have a medical explanation for this reported response?

I'm not challenging the responses that have been reported. Rather I'm probing to see if there's a known or suspected scientific explanation for them.

One possible explanation is that, as we've discussed before, HCG is trickier to dosage correctly.

Originally Posted by SWALE

THEN, when I added in HCG, they felt even better.

Do you have an explanation for this reported response? I've read your description of the hormonal pathways that HCG opens up compared with standard TRT alone. However, if that’s the explanation, then it doesn't make sense to me that men on TRT alone would report feeling better than on HCG alone. It seems to me that it should be the other way around – men on HCG alone should feel better than men on TRT alone.

Originally Posted by SWALE

You are limiting yourself with just HCG. HCG alone simply does not bring the benefits T does. Try it, you will see.

Swale, based on your comments that (a) skipping days on an HCG protocol produces roller coaster T levels and (b) the body likes consistency, I decided to switch my HCG only protocol from twice a week to daily. Actually, nightly (shots taken at bedtime) because I believe in following the circadian rhythm. My new HCG shot dosage is 65 to 70 IU every night before bed.

I don't have blood tests yet, but so far I like the new regimen.

Thanks for your comments and suggestions!

[stat1951]

I have just started looking around for information on this also.

QUOTE:
Do you have an explanation for this reported response? I've read your description of the hormonal pathways that HCG opens up compared with standard TRT alone. However, if that’s the explanation, then it doesn't make sense to me that men on TRT alone would report feeling better than on HCG alone. It seems to me that it should be the other way around – men on HCG alone should feel better than men on TRT alone.
END QUOTE

That seems like that's how it should work to me also. It seems to me that it should be the other way around – men on HCG alone should feel better than men on TRT alone...

Question: Does the hCG have to be continued on "forever" or can it re-start the HPAT Axis and resurrect one's natural production of T?

Am a "newbie" in this game (to some extent anyway), so forgive me if I am overlooking some very basic info etc.

LRS

[DavidZ]

Originally Posted by stat1951

Question: Does the hCG have to be continued on "forever" or can it re-start the HPAT Axis and resurrect one's natural production of T?

I posed this question in another thread. See:
Can HCG Restart the H/P Axis To Become Self-sufficient Again?

Unfortunately, it appears that we don't yet know the answer to this question. My personal experience (discussed in some detail in the other thread) seems to indicate that it's possible but, unless you're a hypogonadism is from steroid use, it's a very slow process.

[Weatherlite]

I'm willing to bet that, for some, to get your T levels high enough with just HCG would require quite a bit of it which would then elevate your E too high. That could cause the disparity between T and HCG therapies. I'm also guessing that since HCG raises other levels that it may raise one of them too high which could cause negatives as well.

As for restarting the HPTA.....I just can't see how this would be possible. HCG basically mimics LH right? So it is suppressing LH production. SO, when you come off of HCG the pituitary won't be producing any. How's this restarting? Although I did just think of one reason. Could it be possible that the gland is overstressed and overworked? Then, by allowing it to shut down production for a while you are giving it a rest. Then, when you come off HCG it's "ready" to go back to work? A theory at least.

[DavidZ]

Originally Posted by Weatherlite

I'm willing to bet that, for some, to get your T levels high enough with just HCG would require quite a bit of it which would then elevate your E too high. That could cause the disparity between T and HCG therapies.

That doesn't make sense to me. For any desired level of T there's a specific dosage of HCG that will yield that amount of T. Finding that specific dosage of HCG is another story.

Originally Posted by Weatherlite

I'm also guessing that since HCG raises other levels that it may raise one of them too high which could cause negatives as well.

That would depend on the amount of HCG each man needs to get their T into the upper normal range. I only need about 410 iu/week to get my T into the upper normal range. Most men need much more.

Originally Posted by Weatherlite

As for restarting the HPTA.....I just can't see how this would be possible.

Here's what Swale said in another thread:

I, too have heard of it happening.

It seems like the body, once equilibrated at a good serum androgen level, seeks to maintain same, and will "pull up" low T levels sans TRT to get back there (sometimes).

It's nothing we can count on, though. The bottom line is that (1) NOTHING will surprise me with respect to the Endocrinological system anymore (2) Mother Nature is, was, and always will be, the boss.

[DLMCBBB]

Originally Posted by DavidZ

Here's what Swale said in another thread:

I, too have heard of it happening.

It seems like the body, once equilibrated at a good serum androgen level, seeks to maintain same, and will "pull up" low T levels sans TRT to get back there (sometimes).

It's nothing we can count on, though. The bottom line is that (1) NOTHING will surprise me with respect to the Endocrinological system anymore (2) Mother Nature is, was, and always will be, the boss.

David,

Swale never said such a thing in regards to hCG "RESTARTING the HP".

Dustin

[DavidZ]

Originally Posted by DLMCBBB

David,

Swale never said such a thing in regards to hCG "RESTARTING the HP".

Dustin

Yes, he did. See his posting in the thread entitled "Can HCG Restart the H/P Axis To Become Self-sufficient Again?" at:

Can HCG Restart the H/P Axis To Become Self-sufficient Again?

[DLMCBBB]

Originally Posted by DavidZ

Yes, he did. See his posting in the thread entitled "Can HCG Restart the H/P Axis To Become Self-sufficient Again?" at:

Can HCG Restart the H/P Axis To Become Self-sufficient Again?

First, the title in question "Can HCG Restart the H/P Axis To Become Self-sufficient Again? was coined by you not him. Second, his response was about the adjustments of hCG.

He wrote:

The body, once equilibrated at a good serum androgen level, seeks to maintain same, and will "pull up" low T levels sans TRT to get back there (sometimes).

So as you can see, he never said hCG helped RESTART THE HP.

I highly doubt he had this in mind, when he said nothing surprises him anymore. He has a lot of clinical experience, yet there comes times when a certain dose of T can put a patient in the upper normal range, whereas others you have to constantly titrate the dosage to achieve the levels of same. Also, it was noticed that patients on TRT, will show a reduction in E. I can't explain the later, but it happens. I think he was steering in that direction.

Dustin

[stat1951]

Maybe SWALE can tell us what he meant by his comments rather than this second guessing?

Also....

Both SWALE and Dr. Shippen seem to have a lot of clinical experiences in this area, but the fact is that their combined practices would account for a very, very small percentage of patients treated for hypogonadism worldwide. Additionally, only a very small fraction of a percent of hypogonadal patients post on the Internet support sites / informational sites. Finally, individuals who had successfully gone through a regimen where their HPA Axis (or HPAT Axis) was successfully re-started would very likely NOT be looking for boards like this to post on. If things are better and where you want them to be and life is good, then most people tend to move on and not continue to hawk board such as this.

I know that psychiatric researchers have found that many people with severe depression have highly elevated (well above maximum normal ranges) of cortisol levels (these being non Cushing's Disease individuals) and that the research indicated that their HPA Axis as related to cortisol production was out of kilter. Clinical studies have shown that short-term application of RU-486 (an extremely strong anti-cortisol drug originally developed in France for Cushing's Disease patients which then became infamous as the "abortion pill") not only relieved their severe depression but apparently "re-set" their HPA Axis and resulted in the return of normal cortisol secretions. The short-term applications in these trials were in the range of 4 - 7 days.

I show this example just to address the fact that - in at least the area of cortisol production - it seems that the HPA Axis can be "re-set" fairly readily.

I guess what I'm looking for if anyone has ever done any PubMed searches or other related medical / clinical trial studies to see if the HPAT Axis has been successfully re-started in appropriate cases (is it primary hypogonadism or secondary hypogonadism - and how does one tell the difference absed upon what test result readings)? And whether or not other substances than simply hCG have been looked in to???

In my situation, I have possibly a Pheo tumor which generates chronic secretion of adrenaline and its various co-factors. That then frequently causes - as appears to be the case in my situation - severe anxiety which then causes a simultaneous high production of cortisol. High levels of cortisol basically screw up all of your other hormones as well as your nervous system, etc. In going through Cushing's Support boards on the Internet, I find it very interesting that many of the male posters also report hypogonadal symptoms.

In my case, I was not hypogonadal for years nor did the hypogonadal state slowly appear. It literally appeared overnight within two weeks of a sudden onslaught of severe anxiety (caused possibly by this potential Pheo tumor) - along with several other unrelated physical symptoms (tinnitus, periphernal neuropathy type pains, flushing/itching symptoms of upper torso, a prostatitis type symptom - that actually seems more like an UTI - that comes and goes,
etc.).

So I wonder if the Pheo tumor has caused the "interference" with the HPA Axis and if surgical removal of the Pheo will "fix" the hypogonadal situation - or at least allow something like hCG to "re-set" the HPA Axis....

[DavidZ]

Originally Posted by DLMCBBB

First, the title in question "Can HCG Restart the H/P Axis To Become Self-sufficient Again? was coined by you not him. Second, his response was about the adjustments of hCG.

Swale was responding to the entire thread, including the title.

Originally Posted by DLMCBBB

He wrote:

The body, once equilibrated at a good serum androgen level, seeks to maintain same, and will "pull up" low T levels sans TRT to get back there (sometimes).

So as you can see, he never said hCG helped RESTART THE HP.

Do you know what "sans" means? It means "without."

I agree that Swale could have been implying that TRT could restart the H/P axis, but given the topic of the thread, I don't think that's what he was saying.

Originally Posted by DLMCBBB

I highly doubt he had this in mind, when he said nothing surprises him anymore.

I disagree. But as stat1951 said, why don't we let Swale tell us what he said/meant rather than debating it between ourselves. Besides, this conversation belongs in the "Can HCG restart the H/P Axis" thread, not this one.