Starting HCG

[SinginHawk]

When you start on HCH 1 shot every 3rd day, do you immediately back off on the gel dose you are on or wait to get levels then adjust. I just started 1 1/2 Testim and plan on starting HCG. I don't know what my present level is but last time on 1 1/2 it was 522 with 159 free.

[mranak]

You wait until the next blood test.

[Weatherlite]

Always wait until your T levels are "stable" and where you want them. Two weeks after starting is usually a good point to get labs done. Once you are satisfied THEN start HcG. And no, don't lower the dose. After another couple of weeks get more labs to see how much the HcG helped and adjust as necessary.

[stat1951]

Originally Posted by Weatherlite

Always wait until your T levels are "stable" and where you want them. Two weeks after starting is usually a good point to get labs done. Once you are satisfied THEN start HcG. And no, don't lower the dose. After another couple of weeks get more labs to see how much the HcG helped and adjust as necessary.

Looking at going up and seeing SWALE sometime soon here (I hope) and definitely want to try his HcG protocol. So when I saw this posting I was quite interested.

If I get this right, I am supposed to get my T levels where I want them - and get them stablilized there... and THEN add the HcG into the mix???

Since I am fairly certain that the HcG is going to raise my T levels (especially if secondary), wouldn't it make sense to lower my externally applied T dose (whether gel or shot) and make any adjustments upwards from there?

Obviously HcG seems to have certain other "feel good" advantages rather than simply just the fact that is raises T, but it DOES tend to raise T, no?

So if my IM shots of T or levels of gel have got my T levels where I want them, then would adding in HcG be somewhat counterproductive at that point? I would think that there would especially be a concern as to increases in aromatase activity, potentially increased DHT to excessive levels, potentially increased hematocrit to excessive levels, etc., etc., would be avoided by doing it the other way.

I had e-mailed SWALE on that very process a couple months or so back, and thought for sure that he had a four week wait for follow-up labs... and that he started out with doing the HcG at a lower external T in order to see just what the HcG was doing without raising numbers too high...

But it definitely could be possible that I misunderstood his response....

Larry

[Weatherlite]

From what I understand when using HcG and gel at the same time you still don't lower the gel dose. I guess for most it won't go over the upper limit.

On Cyp, the HcG is given when the T levels are dropping and will keep your T levels a bit more "stable".

Yes, if the HcG raises your levels above the top of the limit it can have negative effects. I do believe that many who use HcG and gel use a lower level of HcG than those who use Cyp. And if you are secondary and a low level of HcG is too much you can lower you T accordingly. I'm willing to bet that most men would prefer to lower their T dose and keep the HcG for it's size restoring effects!

[stat1951]

Could be.

I was sure that I recently read a couple of SWALE's postings where he discussed hypogonadal males only 5 grams of AG (in fact, I believe he spells out in his protocol that is specifically what he starts with) and 250 IU of HcG every third day.

And specifically one post not too long ago where he had one certain patient who he had doing HcG but at a lower dose of like 100 or 150 IU every day and doing 2.5 grams of AG daily... and that this guy's Total T and Free T were at the "top end of the ranges".

Personally, I think I'd rather start low with T and work my way up into the "optimum ranges" rather than get my T levels up where I like them at and then add HcG to the formula. Just somehow seems that would be a recipe for guranteeing some highly elevated numbers (including things like E2, Total E, and DHT).

HcG obviously has some traits other than just returning "some" testicle size - things like increasing overall T and also some sort of "feel good" factor as so many guys report feeling so much better when incorporating HcG along with their T.

Jeez, I wish I could get to SWALE fairly soon here. Oh well, just keep plugging at it I guess.

Larry

[Weatherlite]

Remember to take it one thing at a time and to not expect results overnight.

[pmgamer18]

Originally Posted by stat1951

Could be.

I was sure that I recently read a couple of SWALE's postings where he discussed hypogonadal males only 5 grams of AG (in fact, I believe he spells out in his protocol that is specifically what he starts with) and 250 IU of HcG every third day.

And specifically one post not too long ago where he had one certain patient who he had doing HcG but at a lower dose of like 100 or 150 IU every day and doing 2.5 grams of AG daily... and that this guy's Total T and Free T were at the "top end of the ranges".

Personally, I think I'd rather start low with T and work my way up into the "optimum ranges" rather than get my T levels up where I like them at and then add HcG to the formula. Just somehow seems that would be a recipe for guranteeing some highly elevated numbers (including things like E2, Total E, and DHT).

HcG obviously has some traits other than just returning "some" testicle size - things like increasing overall T and also some sort of "feel good" factor as so many guys report feeling so much better when incorporating HcG along with their T.

Jeez, I wish I could get to SWALE fairly soon here. Oh well, just keep plugging at it I guess.

Larry

Larry you make some good points here but that is not how SWALE does it. He gets one stable like in 2 to 4 months for a new guy then adds HCG. Some men on HCG don't get higher T levels but there testis still full out and like SWALE told me when I posted that my Dr. felt that HCG would not do anything for me because I am primary. Here is what his said. "He (being my Dr.) 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 pergnenolone 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."

So if you do see him I am sure he will not drive your levels to high. But what if one does less T meds before adding HCG and there levels don't go up then this poor guy is going to suffer a set back. I would not wish this on anyone.

[stat1951]

Phil.

Okay, see what you're saying, but I believe with his protocol that SWALE is primarily talking about a new TRT patient who hasn't been on TRT previously when he discusses particulars in his protocol - and not so much an individual who has been on TRT for some time. (my interpretation anyway).

As he said: "First, you have not lost all Leydig cells, so any HCG you take will stimulate those who still function to produce endogenous testosterone."

So for most guys - even primary hypogonadals like yourself, Phil, who were primary for years and years - they still do have Leydig cells that function to produce their own (endogenous) testosterone. So it seems to be simple math.

If Patient A has been doing 10 grams of Testim and has Total T levels of 800 and E2 levels that are borderline, but okay, then it seems to me that adding in 250 IU of HcG every third day is going to (most likely) significantly increase his Total T (and also E2). I believe I read in one of your posts where your Total T levels doubled when you added in HcG (*).

So if I get this right, if I am doing 10 grams of Testim and levels still not quite where I want them so I increase to 15 grams of Testim and now have excellent levels of Total T and Free T but want the benefits of the HcG protocol, that I then ADD in HcG at 250 IU on every third day?

And then if levels are too high - likely since I already had top levels of T - that I then work Testim levels back down??? And probably have to deal with elevated E2 as a result?

Okay.

Just seems, well, strange...

Larry

[pmgamer18]

Hell when you put it that way makes a good point but are you doing 15 grams of testim. I tryed it and it did drive up my E2. Also I am doing a lot more HCG a week then you are talking about. I feel it would not matter unless the HCG did not raise your T levels.

[stat1951]

No Phil, that was a theoretical example. But one that would still need an answer.

I personally am on 10 grams of Testim for now, and believe my levels to be around 600 - 650 Total T. I was last tested at 10 grams of AndroGel (500 - 550 in range of 240 - 1000) and when I asked my PCP doc about testing after switching over to Testim he replied "why? they're the same thing, same strength, same dosage..." Yes, switching over to shots could be a possible answer, but raises some interesting conflicts:

1. My PCP doc and endos I've checked with around here believe that 200 mg IM shot once every two weeks is "advanced TRT". Some still believe in 400 mg IM shot once every month.
2. Phil as I recall, when you switched over to shots, you were still have significant problems with your TRT program. I can dig up the posts from then if you don't recall (around March? April?). You were still pretty miserable with doing the shots in lieu of the gels.
3. It still gets back to the same question. If I am at 800 - 900 on the IM shots and add in the HcG protocol, my T levels still should rise drastically (or in an attempt to balance things out, my body increases E2 and DHT levels, etc.)

Anyway, if one has built their T up to the higher levels they want (using gels or Test Cyp, etc.) and then ADDED in HcG, it just seems obvious that their T levels will increase yet further. As E2 in males is primarily a matter of the aromatse factor - especially older males - and the higher your T, the more active the aromatase factor, well, it just seems like doing the TRT in this fashion is bound to result in higher E2 levels. Possibly even (likely?) overly elevated E2 levels.

I note one of SWALE's patients who is doing "awesome" (SWALE's words) on 2.5 grams AndroGel daily along with 150 (I think - may have been 100 IU) IU of HcG daily. And his Total T and Free T are in the "upper limit" of his reference ranges with excellent E2 and DHT.

Obviously this patient didn't get his T levels up into the optimum range on just 2.5 grams of AG. Obviously it was the added HcG which increased the levels of Total T (and Free T).

Phil, I also note that when you added HcG into your protocol, that your T levels almost doubled. So the patient who gets their T levels up to 800 on Testim and then adds in HcG and then doubles their T levels to 1600, then what?

It just seems to make sense to me (and I understand I'm no master of the subject) that aside from all of its other benefits (testicle size increases, "feel good" facto, etc.), that HcG is also going to increase the T that one has circulating on any given week. So to work one's T up to optimal levels on external T first and then add HcG seems like it would be asking for potentially excessive levels (if not of Total T then at least of E2, etc., as the body tries to compensate).

Oh well, I'll worry about that aspect when I get there.

Larry

[pmgamer18]

First thing is what your Dr. said about testing you need to be tested every 4 to 6 weeks for sometime when just starting on TRT your body can eat up your T meds your stress can do your meds in. And yes I feel that you should cut back on Testim when you start on HCG. But we are not the same I eat my T meds up fast this is why I need so much. I was doing bad on the gels with low levels and joint and muscle pain. When Norton told me he tryed the gels and got sore joints and muscles. He went back to shots I told my Dr. about this and reminded him that when I was doing shots 200 mgs. every other week and when I got a bladder infection my levels would fall and I would get sore joints and muscles he added shots to the gels. I felt much better but doing this drove up my E2. And the higher my E2 got the lower my T levels went. So when I was first tested for E2 and got it down my levels jumped way up over the top of the range and my Dr. stopped the gels and went back to shots but this time every week. My T levels in the past have always been over 800 more like 1000. On shots every week my T only went up to 550 doing 100 mgs. a week so he upped the shot to 150 this got my levels up to 600 still to low. This is when I asked him to try HCG you know the rest of the story. So my levels were to low before I started on HCG and yes they went up from 600 to 1138. So if your levels are 800 and you try HCG and it works for you like it did for me then your T levels will go higher to high.

[frankwhardy]

Phil, based on what I've experienced so far, I'm starting to think that my situation is going to turn out nearly identical to yours - my body seems to be *very* rapidly eating up the T-cyp shots as well. I'm also seeing the same effect you noticed where a higher dose at a longer injection interval actually works better, overall, than a smaller, more frequent dose. Just shows that what sounds good in theory (i.e., trying to level out the peaks and valleys) isn't always as good in practice, and also shows how different everyone's body is.

Larry, I follow what you're saying and you're right. I think it's a situation, though, where probably the majority of people who do non-HCG TRT and who are actually able to titrate their T to the correct level, whether by injections and/or transdermally, will be happy with their TRT and won't feel the need for supplementation with HCG. So the issue would never arise of having to lower your dose of T to compensate for the increased amount of T that your body is stimulated to produce via the added HCG. Based on what I've read, I also have a feeling that testicular atrophy is not a certain consequence of TRT by any means and that this only happens to a minority of people (someone please correct me if I'm wrong). And adding HCG doesn't mean you're going to be guaranteed an extra feel-good effect (even though, for example, it might help with a testicular atrophy problem). So if a person is feeling good on their injections or gels, and having no annoying testicular atrophy-type problems, the HCG will never enter into the picture. In otherwords, to have the best result it won't necessarilly be the case that a person will have to use HCG. (Based on how I'm tracking Phil, though, I've got a feeling that I'll need to use it if for no other reason than to avoid massive amounts of externally applied T.)
Frank

[stat1951]

Frank,

Thanks for input, but personally, I am seeing more and more of just the opposite.

Hypogonadal males who have seemingly good (or decent) numbers but want to add in the benefits of HcG - and not just counting that it adds extra T into the formula. There's also the testicle increasing element (which SWALE's practice has shown that HcG restoring some degree of testicle size does have a mental effect on a huge number of his patients) and, the increased libido usually brought on by addition of HcG, and then there's the simply "feel good" effect that HcG brings in to play.

For example, I have Total T ranges currently of around 600 (not excellent, but decent) and Free T (excellent percentage for Free T) of just over 180... but just don't feel that I am where I should be at. Libido remains somewhat poor (better than before hypogonadal state came on, but less than what it was a couple years ago) and I just "don't feel right".

From the posts that I read, I find that there seems to be moer and more hypogonadal patients more and more interested in incorporating HcG into their TRT protocol.

And, from what I can see, for VG cause.

And, Phil, yes, I believe that you now see my point...

Larry

[BDATI2D]

Not to butt in but everybody here has a good point. The one thing that makes SWALE's HcG protocol make more sense is the fact that everybody is going to react differently to HcG depending on how many leydig cells are still active. So it would seem that one would not want to lower their dose of T until after you have been on HcG for a while and stabilized.