Ok that sounds like standard protocol. I see nothing wrong with it except for the infrequent HCG injections. As for your labs results, we see your results but not the range for each test. Each lab has their own standard ranges.
I agree with above. Standard prescription. It’s good to see HCG even being used. And glad it’s not a 1k IU dose, but concur that it’s a little too infrequent. I’d suggest 150-250 IU m/w/f. M/Th at least.
Thanks man I’m new to this so appreciate the personal experience. Is it bad if I start low as he recommended? Or should I press him to up it if I want kids while starting trt. We do plan on wanting another soon.
You’re welcome. Did he suggest checking your sperm? Then you can see if what you’re doing is working. I think a good doc would increase it until it does the job.
No I haven’t started TRT yet, waiting to pick up script from pharmacy this week.
Our initial consult I told him I did want kids soon and that’s why he included the HCG and explained to me how and why it works for fertility.
Maybe run this for a 4-6 weeks, and when I go for my first labs, I’ll get my sperm count done at same time and see where im at? Then get him to reassess?
Higher doses are required for people who have been on TRT for a long time.
Without the variable of protracted HPTA suppression being present, low doses of HCG can maintain intratesticar testosterone production and therefore the individual won’t become azoospermic.
@EnhancedToronto it should be noted with a total testosterone of around 230ng/dl + FT in the gutter, there’s the chance you will have a low sperm count regardless. You need to know what the eitiology behind your hypogonadism is
"Functional’’ hypogonadism is becoming more and more common. That is hypogonadotrophic hypogonadism mediated by poor diet, sedentary lifestyles, environmental pollutants etc. Functional hypogonadism can be associated with a low sperm count, but it would be unlikely you’d have complete azoospermia.
If you’ve got a disorder like klinefelters syndrome… hcg isn’t going to help you.
The average testosterone (across all age groups) level has declined quite a lot over the past 50 years. A decent portion of men now fall off into symptomatic territory.
Say there’s a box plot. Interquartile range would have perhaps been 450-900 back in the day whereas that now seems to be more like 350-700. With 25% (i’m pulling these stats out of nowhere) or so falling below that.
Cutoff values as to when a man becomes symptomatic are so variable from person to person… but data generally indicates a free testosterone level below say 300pmol/l is when MOST men will start to become symptomatic.
Free testosterone is more important than total testosterone, but you’d be hard pressed to find a man with a total testosterone level of 300-350 or below who isn’t starting to exihibit a few signs of testosterone deficiency.
Depending on how low that number gets depends on the symptoms present.
One could merely lack energy, or they might be developing insulin resistance, abnormal adipose tissue deposition (also mediates insulin resistance), reduced muscle bulk.
There’s also a correlation between low T and cardiovascular disease; and while low T doesn’t appear to increase the risk of prostate cancer (prostate cancer tends to be androgen sensitive)… those who acquire prostate cancer who already have low T to begin with tend to have more aggressive cancer… as to why? Who knows… not enough research
You are (probably) better off on the T… but 200mgs/wk is an aggressive dose. Most men are fine with 0.5ml once per week.
But you can try 200mgs… I personally always felt ‘amped up’ and full of adrenaline on that dose. It wasn’t a feeling I was comfortable with. It should also be noted long term outcomes associated with higher doses like 200mg are unknown. The longest study looking at 200mg/wk to my knowledge was 18 months in duration.
The dose in mg/wk isn’t the deciding factor… it’s where that dose gets you to. If you take 200mg/wk and peak at 1050, nadir at 550… and this doesn’t cause you issues with RBC, lipids, PSA, autonomic dysfunction etc… great!
If you peak at 2500 and nadir at 1250 (like many would at that dose)… it’s too much unless you have the words highest SHBG or partial androgen insensitivity syndrome (which you don’t have).