Yippee! First self injection went off without a hitch!

I see.

Well, I'm done with making babies even though we still like to practice once in awhile.

And without the HCG, I have definitely noticed some testicle shrinkage.


Mine are about the size of a green olive.


Which really hasn't been a problem, except........



every time I see a bottle of Gin I get a hard on!

That is correct up to a point.  First the underlying condition has to be such that additional LH will trigger the boys to produce more.  If they aren't capable of producing more testosterone then HCG will do nothing.  Also too much HCG will desensitize the boys to LH, basically burning them out and they will no longer respond to LH.  Not sure if that is reversible.  Since the max amount of HCG is limited, you have a very small range that it would be effective at.  Will that small range be enough to stimulate the boys to produce enough testosterone to get to the levels you want?  Most likely not.  Each person is different and each condition is different.  So it is technically possible but not too likely.  Everything that I have read on this basically says supplemental testosterone is safe, easy, and effective so why mess with HCG.



I can say this from experience.  The combination of clomid and a decent dose of HCG every other day only got my levels up to 800.  They were at 200 before I started the clomid two years ago, so that is a pretty good result.  But it's also not the 1,100 that is the top of the accepted range.  I don't think my numbers would get much higher with a larger dose of HCG and I'm not sure that they would stay that high had I continued with it.

Hello gentlemen!  Today I joined the low testosterone band wagon after receiving my blood test results this morning.  I turn 40 years old on the 23rd of April.

My results:

Testosterone, serum                      225 (348-1197 ng/dL) L

Free Testosterone (Direct)             7.4 (8.7-25.1 pg/mL) L

My doctor prescribed Testosterone creme 100mg/ml to thigh  -  apply 1ml once a day for 30 days.

Will do this for three months until my next blood panel to see where the numbers are.

I was more worried about my thyroid because my family has a history of it and I'm doing just fine there.  I am also low on vitamin D and will be taking that daily as well.

If I may ask, why did you opt for the creme rather than the injections?



 

It had more to do with the doctor than myself when deciding since we are just starting out.  Actually, my lifestyle needs to change a lot to help increase my testosterone levels.  I work the midnight shift, my vitamin D is low, I like to drink and have an occasional smoke when I drink, my diet needs to improve and I need more exercise.  I need to realize I am getting older and have to work on living a healthier lifestyle.  

Edit:  I have decided that for the next three months instead of taking a testosterone supplement I will work on being a healthier person instead then decide what action to take.  I am in this situation because I have become lax in my health as I grow older.  I don't want to supplement a problem due to my poor choices.  My poor choices need to be rectified before I start treatment.

You need to go to the website www.allthingsmale.com and download Dr. Crislers recipe for success with TRT and give it to your Doc.

It may be vanity, but I have to admit that it is nice to finally see some results from working out and the beginnings of pectoral muscles again.

Also, I've learned that massaging the injection site really helps prevent soreness the following day.  Other things I've learned about giving myself injections:  1.  It helps to pay attention and avoid going through the veins just under the skin.  2.  I still have a bit of a pyschological aversion to stabbing myself that I have to overcome with each injection.  It takes a bit of "stiff upper lip" to push through the skin, though a couple of seconds later I'm fine.

I was searching for information on HCG, unfortunately most of the resources I found were on illegal sites. I found this, its author is clearly talking about illegal steroid use, but its about the best HCG article I could find. They're talking about "cycles" but I'm guessing the same principles apply to TRT.

HCG – Unraveled
Posted on October 11, 2009 by Eric Potratz

Post-Cycle-Therapy is a must upon cessation of steroid use. Many great Post Cycle Therapy protocols have been outlined over the years, and many individuals have had success with following such protocols. Nevertheless, what works can always work better, and I intend to show you the most effective way to recover from AAS. This is especially the case for those that have had a lack of success following popular advice. In this article I will address the misunderstanding and misuse of Human Chorionic Gonadotropin (hCG) and show you the most efficient way to use hCG for the fastest and most complete recovery.

HCG unraveled –

Human Chorionic Gonadotropin (hCG) is a peptide hormone that mimics the action of luteinizing hormone (LH). LH is the hormone that stimulates the testes to increase testosterone levels. (1) More specifically LH is the primary signal sent from the pituitary to the testes, which stimulates the leydig cells within the testes to produce testosterone.

When steroids are administered, LH levels rapidly decline. The absence of an LH signal from the pituitary causes the testes to stop producing testosterone, which causes rapid onset of testicular degeneration. The testicular degeneration begins with a reduction of leydig cell volume, and is then followed by rapid reductions in intra-testicular testosterone (ITT), peroxisomes, and Insulin-like factor 3 (INSL3) – All important bio-markers and factors for proper testicular function and testosterone production. (2-6,19) However, this degeneration can be prevented by a small maintenance dose of hCG ran throughout the cycle. Unfortunately, most steroid users have been engrained to believe that hCG should be used after a cycle, during Post-Cycle-Therapy. Upon reviewing the science and basic endocrinology you will see that a faster and more complete recovery is possible if hCG is ran during a cycle.

Firstly, we must understand the clinical history of hCG to understand its purpose and its most efficient application. Many popular “steroid profiles” advocate using hCG at a dose of 2500-5000iu once or twice a week. These were the kind of dosages used in the historical (1960′s) hCG studies for hypogonadal men who had reduced testicular sensitivity due to prolonged LH deficiency. (21,22) A prolonged LH deficiency causes the testes to desensitize, requiring a higher hCG dose for ample stimulation. In men with normal LH levels and normal testicular sensitivity, the maximum increase of testosterone is seen from a dose of only 250iu, with minimal increases obtained from 500iu or even 5000iu. (2,11) (It appears the testes maximum secretion of testosterone is about 140% above their normal capacity.) (12-18) If you have allowed your testes to desensitize over the length of a typical steroid cycle, (8-16 weeks) then you would require a higher dose to elicit a response in an attempt to restore normal testicular size and function – but there is cost to this, and a high probability that you won’t regain full testicular function.

One term that is critical to understand is testosterone secretion capacity which is synonymous to testicular sensitivity. This is the amount of testosterone your testes can produce from any given level of LH or hCG stimulation. Therefore, if you have reduced testosterone secretion capacity (reduced testicular sensitivity), it will take more LH or hCG stimulation to produce the same result as if you had normal testosterone secretion capacity. If you reduce your testosterone secretion capacity too much, then no amount of LH or hCG stimulation will trigger natural testosterone production – and this leads to permanently reduced testosterone production. (recovering full testosterone production is a topic for another article)

To get an idea of how quickly you can reduce your testosterone secretion capacity from your average steroid cycle, consider this: LH levels are rapidly decreased by the 2nd day of steroid administration. (2,9,10) By shutting down the LH signal and allowing the testis to be non-functional over a 12-16 week period, leydig cell volume decreases 90%, ITT decreases 94%, INSL3 decreases 95%, while the capacity to secrete testosterone decreases as much as 98%. (2-6)

Note: visually analyzing testes size is a poor method of judging your actual testicular function, since testicular size is not directly related to the ability to secrete testosterone. (4) This is because the leydig cells, which are the primary sites of testosterone secretion, only make up about 10% of the total testicular volume. Therefore, when the testes may only appear 5-10% smaller, the testes ability to secrete testosterone upon LH or hCG stimulation can actually be significantly reduced to 98% of their normal production. (3-5) So do not judge how “shutdown” you are by testicular size!

The decreased testosterone secretion capacity caused by steroid use was well demonstrated in a study on power athletes who used steroids for 16 weeks, and were then administered 4500iu hCG post cycle. It was found that the steroid users were about 20 times less responsive to hCG, when compared to normal men who did not use steroids. (8) In other words, their testosterone secretion capacity was dramatically reduced because they did not receive an LH signal for 16 weeks. The testes essentially became desensitized and crippled. Case studies with steroid using patients show that aggressive long-term treatment with hCG at dosages as high as 10,000iu E3D for 12 weeks were unable to return full testicular size. (7) Another study with men using low dose steroids for 6 weeks showed unsuccessful return of Insulin-like factor-3 (INSL3) concentration in the testes upon 5000iu/wk of HCG treatment for 12 weeks (6) (INSL3 is an important biomarker for testosterone production potential and sperm production) 20

In light of the above evidence, it becomes obvious that we must take preventative measures to avoid this testicular degeneration. We must protect our testicular sensitivity. Besides, with hCG being so readily available, and such a painless shot, it makes you wonder why anyone wouldn’t use it on cycle.

Based on studies with normal men using steroids, 100iu HCG administered everyday was enough to preserve full testicular function and ITT levels, without causing desensitization typically associated with higher doses of hCG. (2) It is important that low-dose hCG is started before testicular sensitivity is reduced, which appears to rapidly manifest within the first 2-3 weeks of steroid use. Also, it’s important to discontinue the hCG before you start Post-Cycle-Therapy so your leydig cells are given a chance to re-sensitize to your body’s own LH production. (To help further enhance testicular sensitivity, the dietary supplement Toco-8 may be used)

Based off the above information, an optimal dose of hCG during the cycle would be 250iu every 4 days, or as a less desirable alternative, once a week shot of 500iu. Keep in mind, that the half-life of hCG is 3-4 days, while the half-life of LH is only 1-2 hours. Considering this difference in excretion time, it is best to space each dose of hCG at least 4 days apart for the optimal “peak and valley” replication. However, going more than 7 days between each hCG shot may promote increase the rate of desensitization from lack of LH or hCG stimulation.

Two things that can make it easier, first, pick the spot where you're going to stab then thump it a few times, it numbs the spot so the prick isn't as noticeable. You can also hold an ice cube on the injection site. The other thing you can do is cough the moment you stab yourself. This generally works better when someone else is sticking you, esp. for kids but it's a known technique they teach nurses.  One other thing is don't look, watch something on TV etc.





 

Thanks for the suggested techniques.  I'll try each of them out over the next few weeks.

I recently requested some blood tests.  


 


Estradiol 68 pg/ml. Reference range is <11.8-39.8





Total T  801 ng/dl Ref Range 300-890





Free T 174 pg/ml ref range 47-244





SHBG 29 nmo/l ref 11-80





FSH <0.3 MIU/ML Ref 1.4-18.1





LH  <0.1 MIU/ML Ref 1.5-9.3





PSA 1.8 ng/ml ref 0.0-4.0





Prolactin 10.61 ng/ml ref 2.1-17.7





Cortisol 13.6 ug/dl ref AM 4.3-22.4  PM 3.09-16.66





Vit D  7 L  ng/ml ref 30-90





Vit B 12  300 pg/ml ref 211-911
I asked for a Zinc test but it apparently wasn't done. I haven't spoken with a Physician yet, but it seems as if I have too much Estradiol and not enough Vit D


I have been reading about Aromatse inhibitors and it seems that Tamoxifen is referable to Anastrozole for controlling Estradiol, but both have potential downsides.  



 
 

Are you taking any supplemental testosterone?  I would be more concerned with your LH and FSH are almost non-existant.  They are what drive the natural production.  The estradiol is a little high, are you sure you got the ranges right?  They might have changed them recently but they used to be 40-115.  There has been several discussions in thread about keeping it between 20-40.  At 68 the number isn't too high.  I would be suprised if a doctor would prescribe you anything.  Tamoxifen is the generic Nolvadex and Anastrozole is the generic Arimidex.  Both are SERMs, selective estrogen receptor modulators, meaning they block the estrogen from binding to the receptors but you still have the same amount estrogen you body.  The new favorite seems to be Aromasin, which actually eliminates the estrogen.  I don't know much about it but I do know it is very expensive.



If your doctor won't prescribe Arimidex and you want to try it anyway, there are plenty of ways to get it.  My estradiol number was over 200 at one point and the doctor didn't care.  Let me tell you that high of a level really sucks.  When you become all emotional just like a woman then you know something is up.  It did give me a better understanding of why women are the way they are though and the fact that there is nothing they can do about it.



If you aren't taking any type of supplemental testosterone you could try Clomid, which is another SERM, but it will also break the negative feedback loop and push your LH and FSH up.

Nolvadex/Tamoxifen and Clomid/Clomiphene are SERMS, Arimidex/Anastrozole and aromasin/Exemestane are aromatase inhibitors. SERMs bind to the estrogen receptor (there's alpha and beta) and do not activate it. This is helpful in the hypothalamus as it senses estrogen and that inhibits GnRH to the anterior pituitary (which releases LH). Aromatase inhibitors bind to aromatase and deactivate it. Aromatase changes androgens into estrogens (androstenedione to estrone and testosterone to estradiol).

Note that estradiol binds to estrogen-receptor(ER)-alpha and ER-beta equally well. Estrone binds to the ER-alpha, which has beneficial effects to glucose entering the cells (insulin sensitivity), whereas estradiol slightly inhibits insulin's action

Yes, as a matter of fact I am having heart issues. I have random rapid heart rate –– I forget the technical term. I have been on meds for that but after several months of taking enough pills in the morning to call it breakfast, I have asked for a consult for ablasion(?sp) and see where that takes me. I AM feeling better and feel like going out for a walk after dinner which I didn't before the T. But damnit, I want the wood back. You mention plaque buildup, do the do a dusting and cleaning on guys to get rid ofthat plaque? Where do I turn for that?

To my knowledge, which is exceedingly limited, you can't get rid of plaque. Just like plaque in the cardiac arteries cannot be removed. It is my understanding that the reason that Viagra and such drugs work is that they cause the blood vessels to relax, thus allowing more blood to bypass the plaque constriction.  Plaque in the cardiac arteries is dealt with by implanting stents. Again, let me reiterate that my knowledge is very limited. I hold a steering wheel for a living and folks like me are not known for our genius or cognitive abilities.
 

Any of yall on t supplements take any vitamins in addition? I take 2000 iu of Vit d a day and 500 mg vit c. I noted I don't get sick as much and since I've started taking this daily I feel a bet better, but still no where near where I should be.

Taggie.

Well that's not good news.  Basically unless you start the HCG before or concurrent with TRT, HCG is not going to do anything for you.  

I take fish oil every day.  But I've never tested to see if I'm deficient in any vitamins, and I've never really seen any good evidence either way that taking vitamins would help.

Not true.  My test levels were ranging 200-300.  Because my wife and I are planning on having children, the doctors advised against TRT because that can impair fertility (so they said), so they recommended HCG.  

I started off with 500 IU every other day, 3 days a week, test levels went to 800, so they brought me down to 300 IU every other day, 3 days a week.

As long as you respond to LH, then you should respond to HCG as well.

Those of you on shots, were you on the gels before.  I'm now maxed out on the Androgel 1%.  The doc has been increasing my dosage slowly over the last 12 months.  Everything is good for a while and then my T levels drop off so he increases the dosage.  

Just wondering if anyone has had the same issue with gels?


Also those of you on the shots, were you able to stabilize your T levels and keep them stable without having to constantly increase the dosage like I'm doing with the gel?

I started with the shots and I'm still doing the shots.  My levels have been stable, but still don't feel very high compared to the amount I'm injecting.  I'm a big guy, so I'm not sure if that's related or not.

I should have worded that better.   As I read that article HCG is not going to help in restarting your testicles if you shut them down by taking T due to de-sensitizing them to LH.  

Theres that avatar again...damn you.

I went directly to self injections. At first a big dose, infrequently but blood results and my pleas with
the Dr now have me on .75cc of 200 T. Cyp weekly. Bioavailability of T Cyp is 5-7 days. Dosing once
a month is like being on a horny/emotional/rage filled roller coaster.  2 weeks on top of the world, 2
weeks in the gutter.  It was hard for my Dr to let me go to weekly injections as he wanted me to go to
creams, which I refused to do. My dosage seems to keep me within the ranges my Dr wants to see.
Never too high, never too low.

Started with the gel.
Good response at first then it started falling off.
Dr. doubled the dose and it helped for a while and then started falling off again.
Started weekly injections and the level has been stable at the top of the scale. No increase in dosage. Been at the same dose for injections for about five months now.
The gel totally sucked in Houston's summers. Had to apply that crap all over both shoulders and it never quite dried with our humidity. It also smells bad. Injections are the way to go if you can do it.

Looks like I need to ask my doctor about HCG right away before it's potentially too late.

I'm in Dallas and right now it's not that bad but slathering 8 pumps of that stuff a day on is getting old.  

If you don't mind what's your dosage and T levels look like?

My doc shit a brick when my test levels jumped to 900 last year right after they put me on andro.  He was happy when they hit 500, unfortunately I wasn't.   What's worse is they continued to drop, so I started the cycle I mentioned earlier.

I started the shots of cypianate (sp) about 6 weeks ago.  Once a week in my butt cheek.  So far so good, I feel much better and I am putting on muscle in the gym.

Are you giving yourself your shots or getting them at the doctor's office?

It's really never "too late" but the later you go the longer it will take to restore what was lost.  Chances are pretty high that you will not find a doctor to prescribe HCG.  They are few and far between.  There are other alternatives if the doctor doesn't want to participate.

By saying it is never too late the body builders would go 12 weeks on a high testosterone cycle, everything would shut down and atrophy.  Then they start their post cycle therapy to get everything restarted.  Clomid is part of the standard treatment in getting things kick started.  It is actually what my doctor put me on to treat my low T.  Of course he was pretty much accusing me of using steroids at some point and having my natural production shut down even though I had never touched them.

Taking a low dose of HCG while taking supplemental testosterone is the best way to prevent testicular atrophy.  Unfortunately Canada is more accomodating in this treatment than the US is.

First off, there is now a 1.62% Androgel which permits you to apply less gel to get the same amount of testosterone.  Some guys don't do well on the gels because they don't absorb the gel very well.  I have done the gels and did pretty well on them, but did need to increase the dose until about the max amount to feel good.  I switched to shots and did OK...decent levels, but didn't feel as good as I did on the gel.  I am now trying the Testopel implants and am only at week 2, but feel pretty good.

I would say go to the 1.62% and if that doesn't help you, ask your doctor if you can try the injections.  The injections are generally much less expensive than any of the gels, which are still on patent.

Hey...my doc. (endo) did that to me too.  My total level was just under 800, I was feeling great, and he cut my dosage in half.  Then he got "fired" by me.  i went to a urologist and am currently more satisfied with how he manages me.

Yes and the other guy above is exactly right in that if its not started soon after, within a few weeks, permanent damage can occur. The right treatment might be able to bring them back, to what degree who knows

I used to take 4-5 fish oil pills per day. This does have drawbacks on the immune system. EPA in fish oil suppresses T lymphocyte production.

Fish oil-fed mice have impaired resistance to influenza infection.
Leukocyte numbers and function in subjects eating n-3 enriched foods: selective depression of natural killer cell levels
Dietary n-3 polyunsaturated fatty acids promote activation-induced cell death in Th1-polarized murine CD4+ T-cells.
Suppressive mechanisms of EPA on human T cell proliferation.
Dietary supplementation with gamma-linolenic acid or fish oil decreases T lymphocyte proliferation in healthy older humans.
Very long chain n-3 and n-6 polyunsaturated fatty acids inhibit proliferation of human T-lymphocytes in vitro.
Oral (n-3) fatty acid supplementation suppresses cytokine production and lymphocyte proliferation: comparison between young and older women.

I found it because for years I was searching for the cause of my poor immune system. As soon as I stopped taking fish oil, my cuts healed 10x quicker, I stopped being sick all the time, and I feel healthier. It appears eicosapentaenoic acid (EPA) is to blame.

There's quite a few other omega-3 fatty acids. They seem safe so far

Has this been discussed here before? I have noticed that since I started T replacement I have not had one migrane. I used to get them about once a month.

That is a huge blessing!

So, in regards to what it does, how different is taking Clomid from taking HCG?  I ask because I'd prefer to get the benefits from a pill instead of having to inject myself extra times.

Just shoot it with the Test.

Already taking Test C injections..  I'm thinking about preserving the testes.