Well I’ve seen some doctors that are doing both
The argument is that HCG not always stimulates sertoli cells. In fact up to recently it was believed it does not stimulate them at all
That’s the problem of the internet. You are using the correct terms but not in the correct context.
It makes no sense since the HPTA is shut down.
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So HPTA restart and HcG only is an option to save the money for the expensive FSH therapy?
hCG will shut down your HPTA (so will exogenous T). the hCG acts like the LH and this will stimulate testicular T secretion. T metabolizes partly in estrogen and this provides the feedback to the pituitary → shut down
If you want to stay fertile and need to increase T its:
either Clomid only (no hCG or exogenous T) - which will stimulate the pituitary (and not shut it down) to secrete more LH and FSH
OR
hCG (with or without exogenous T) to stimulate spermiogenesis and if this is not enough then you add FSH
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Hi guys,
I have studied the topic again and do not understand some of the correlations yet.
While rummaging through my bloodwork I noticed that my thyroid gland is not functioning properly. The ultrasound also revealed that it is actually “too small” (16ml in sum). Is my Endo an idiot?
Is there a connection between testosterone synthesis and fT3 ?
Could it be that this problem could explain my low testosterone level (before Nebido)?
Does the low ft3 value also affect hcg monotherapy? (that would explain the low levels)
10.09.19 FT 3 pmol/l 2,7-6,9 2,3
10.09.19 FT 4 pmol/l 10,0-28,0 12,7
10.09.19 TSH μU/ml 0,20-2,00 1,49
Please help me to break it down. I will try everything to have children.
What exactly is your protocol right? Are you taking any thyroid medication?
And whats your primary objective? I guess becoming fertile right?
Currently I am taking 750 I.E. HcG EOD sc. (since 12/19) and 25mmc L-Tyroxin (new)
My primary objective is to become fertile → best without FSH and Hcg injection
That was on how much hCG?
For me 350IU hCG eod brought my T to 550 ng/dl (around 19 nmol/l), but everybody seems to respond differently to hCG. I needed to add 75 IU FSH twice per week to get sperm concentration to over 30 mil/ml. I know the FSH eg Menopur is quite expensive.
My second one was concived on 12.5 mg Clomid eod. Raised TT from around to 500 with the same effect on sperm concentration.
If you can afford the hCG/FSH combo than I would go this route for now. Will get you fertile much quicker. Once concived I would stop the hCG/FSH and start the clomid for 3 to 4 months to see how you respond. Good quality food (no dieting), and a healthy lifestyle and then reevaluate after having stopped clomid for 2 to 3 months.
There is plenty of publications available that justifies an off label use of clomi to increase T and sperm count. Go on Pubmed and look for ‘clomiphene testosterone sperm’ and you will find >10 articles. If you need help with finding let me know.
That was on 1500 I.E. 2x per week, only the frequency changed in my protocol
The possibilities with clomid / fsh have already been discussed. The way I see it, my weak thyroid gland blocks the HcG from working properly. My values are very low for the high dose of hcg.
Current Thyroid:
FT3: 1,8 ng/dl (2,2-4,5)
FT4: 0,76 ng/dl (0,6-1,3)
TSH: 1,2 mIU/l (0,3-4)
When hCG is injected to stimulate T secretion from the testicles, thyroid hormones don’t play a role.
Splitting up was a good idea. hCG has a half life of only about 1.5 to 2 days.
Okay, when I get my current T-values, I’ll give you an update. If the T-values are good, I will then request FSH. Let’s hope for the best.
UPDATE:
Albumin g/dl (3,4-5,0) 4,4
DHEA-S µg/dl (80,0-300,0) 267,0
Estradiol pg/ml (0,0-36,0) 29,4
FSH mIU/ml (0,2-10,0) <0,10
LH mIU/ml (0,5-6,0) 0,1
Prolaktin ng/ml (0,00-20,00) 6,05
SHBG nmol/l (9,0-55,0) 38,3
IGF1 ng/ml (120,0-190,0) 142,0
Testosteron nmol/l (6,2-26,2) 10,5
Testosteron ng/dl 303
Thats on 750 I.U (I.E.) EOD. 8 weeks on that protokol.
T is still to low for me.
How would you increase the dose?
The doctor suggests 3x 1500 I.U. per week.
I would prefer 1000 I.U. EOD.
Do you have any suggestions?
You are going into too high doses that may have risks. I think HCG mono will not work for you and it is much more safe to start testosterone treatment.
You are certainly an atypical responder to hCG. Essentially your T levels didn’t change in comparison to the last test.
Yes increase the dose of hCG. Either go with the 1500 IU 3x per week or do 1250 eod, it’s about the same weekly dose.
Did you get a sperm test already? How are your current thyroid hormones? Still taking T4 and at what dose?
No, your hCG dose is not dangerous and please don’t add any T for now.
Thank you very much for your detailed answer.
Okay I will change my protokol next week → get a new bloodwork in 6 weeks.
My sperm has already been tested: Azoospermia
Next test in february.
possible start of FSH in April/2020
Current Thyroid hormones:
FT3: 2,2 ng/dl (2,2-4,5)
FT4: 0,77 ng/dl (0,6-1,3)
TSH: 1,2 mIU/l (0,3-4)
25 mmc L-Thyroxin ED, any advice on this?
No need to wait for next week, you can increase your dose with the next injection.
What did the physician say to the thyroid levels? I would increase your dose to 50 mcg if you have that available. TSH is ok, but T4 and T3 are still borderline low.
Azoospermia is to be expected. I guess you will need the FSH (or HMG which is a combo of LH and FSH) to induce spermiogenesis.
With hCG you don’t need to wait 6 weeks to retest, you can already do it after 2 weeks. But I guess the doc is setting that date.
Okay, I will change it within the next inject. That’s what I intended to do, just miscommunicated.
My physician says: “Under L-thyroxine 25 μg daily there is a euthyroid metabolic condition” haha
No problem to increase to 50 μg. I can give it a try. We can rediscuess after the next blood work as well.
Yes, doc set the date, I’ll try to get retested faster.
Little interposed question
:
My E2 has increased from under 20 pg/mL to 29.4 pg/mL since hcg mono therapy.
Is there a solution? I am afraid that the next dose increase will skyrocket my E2.
That isn’t high.
In absolute terms i agree with @ncsugrad2002 that 29 isn’t really high.
However T to E ratio is only, 10 so not really the best.
But I guess you will just have to give it a shot as your options are limited at inducing spermiogenesis.
Try and see, I think you will improve.