Re: Is there anyone using T Cyp in conjunction with HCG
happy to answer questions.....far from an expert but have been living this for over 5 years and have dedicated myself to education on the subject since day one.
That said....you first need to know where your T is at and what the cause is?
Primary or Secondary
If primary than your testes are weak and not producing sufficient T then any type of supplement or HCG alone will do very little as its like adding a turbo to a broken motor.
If you're secondary meaning the Pituitary isn't sending sufflicient single to the Testes to make enough T (that's me) then supplements and HCG may or may not be sufficient to boost the signal to the testes. For me I tried clomid to address this issue and alas it was insufficient.
So first thing you need to do is determine which you are primary or secondary and then figure (if possible.....many times its not) what might be causing the issue.
As for how much to take and frequency etc.....of T and HCG Dosage varies greatly from one person to next. You need to start low and test frequently and slowly increase until you hit your sweet spot (everyone's is different) As for frequency current thought is more often is better.....take dosage and break it up into EOD dosages Also current thought is to inject Sub-Q for both T and HCG
As for other supplements DHEA and Vit D are key for most people in this boat but labs will give you certainty of what you specifically need.
Best bet is to work hard to find a GOOD Doc who treats with TRT on a reqular basis.
Re: Is there anyone using T Cyp in conjunction with HCG
Thanks for the input. I recently saw an endo who did some blood work. He was testing for secondary as my LH wasn't high. He also did a pituitary MRI which showed nothing suspicious. He checked thyroid hormone levels, etc. and found the levels to be normal, although my initial "thyroid-like" symptoms were suspicious, but it is unclear if those were related to a low t level.
One thing that was of major concern to me was fertility and we also had a semen analysis done. I am in my 40s but still want the ability to have children. Anyway, I assumed the SA would yield poor results, as I understand low t has a relation to spermatogenisis. I was surprised to find a relatively high count (62 mil) with most characteristics normal, except motility; however, the high count can offset this. (I realize the t producing cells (Leydig) and the sperm making cells are both in the testes, but they are somewhat different processes.)
All my problems stemmed from an antibiotic regimen that I took for 3/4 mos. I had no problems before that and was as healthy as a horse. I am hoping there is a way my hormone system can snap back into shape. I am moving over to a well known urology practice that specializes in fertility against the background of hormone issues. (The endo I used doesn't focus in this area as much.)
Can I ask you some things:
1) Overall, how does you treatment regimen make you feel? How do you feel everyday? Have you conquered the symptoms of low t...energy, depression, libido, sexual function? Are you basically able to be whole with your treatment program? ie. 100%, 90%, 85% of what you used to be? Are you self-directing a lot of your own treatment? How often do you interact with your doctor?
2) Can you tell me more about your experience with Clomid? Were there any significant side effects? Were you interested in that treatment regimen as it is only involves taking a pill + it's supposed to allow your body to make t on its own?
3) Does using HCG as a stand alone treatment give you the same feeling as t or does one feel different?
Thanks, boscot. I could sure use your valuable input, as this situation has me quite depressed and worried.
Re: Is there anyone using T Cyp in conjunction with HCG
Quote:
Originally Posted by boscot
Yes......I use T-Cyp and HCG on a very frequent basis with very good results
Hi Boscot. Can I follow up with a question? How does the T-Cyp and HCG make you feel with regard to the following:
1) Sexual - libido & ED, orgasm?
2) Confidence
3) Musculature - ability to retain muscle and reduce fat with exercise
4) Clear headedness
I am doing a month long Clomid test, but everything I study/read seems to indicate that ultimately the best overall feeling you can achieve is using a T treatment (with HCG, possibly AI, etc.) There seems a lot of positive response for this type of regimen.
Thanks.
I guess I'm just analyzing options, as I want to know that there some light at the end of the tunnel should other treatments not work.
Re: Is there anyone using T Cyp in conjunction with HCG
Quote:
Originally Posted by davie12
Hi Boscot. Can I follow up with a question? How does the T-Cyp and HCG make you feel with regard to the following:
1) Sexual - libido & ED, orgasm?
2) Confidence
3) Musculature - ability to retain muscle and reduce fat with exercise
4) Clear headedness
I am doing a month long Clomid test, but everything I study/read seems to indicate that ultimately the best overall feeling you can achieve is using a T treatment (with HCG, possibly AI, etc.) There seems a lot of positive response for this type of regimen.
Thanks.
I guess I'm just analyzing options, as I want to know that there some light at the end of the tunnel should other treatments not work.
Hey
here's the deal....
Clomid did nothing for me long term.....
T-Cyp and HCG have helped in every area you list.....only issue I still struggle with some is ED.....its much better than it was but not where I would like it to be considering I am otherwise very healthy extremely fit and mentally all there.
So I would recommend using it but everyones results vary and you won't know until you try and you really can;t tell until you go about a year and get your levels optomized.
Re: Is there anyone using T Cyp in conjunction with HCG
I see you have had the MRI...good. You also should check for hemochromatosis. Do an iron panel. If I remember right it includes iron, ferritin, TIBC and saturation. Post the numbers because many dr's do not know how to interpret them.
Re: Is there anyone using T Cyp in conjunction with HCG
Quote:
Originally Posted by hayfarmer
I see you have had the MRI...good. You also should check for hemochromatosis. Do an iron panel. If I remember right it includes iron, ferritin, TIBC and saturation. Post the numbers because many dr's do not know how to interpret them.
I'm going to pull together the info. Right now I remember:
In early January, when this "crash" first happened:
T=273
TSH=2.07
T4=don't have it, but it was in range
Barebones bloodwork since I assumed it was thyroid so they focused on thyroid hormones
In late January w/endo:
T=148 (I realize horrible number...this was taken at 5pm also)
LH=4
FSH=6
In February w/urologist:
T=100s range (need to get copy of bloodwork)
In March after Clomid for 3 1/2 weeks (50EOD):
T=314
LH=3.6 (interestingly, this is slightly less than the other reading)
FSH=9 or 10 as I remember (I assume this increase is due to stimulation by Clomid)
SHBG=22
Estradiol=45
Free T=he told me it improved and is in range but need to get number
Need to get copy of the rest of bloodwork for my records but was told nothing was out of range.
The uro wanted me to continue Clomid, as he felt there was a chance to boost T more with more time on it plus I did mention there was some moderate symptomatic relief. I decided I wanted to try HCG after talking with others. April 18th I switched to HCG treatment but no bloodwork was done at the time of switch to HCG. So there was approximately an extra month on Clomid before going to HCG. I believe Shippen even has written that multiple months is needed on Clomid to get good rise in numbers sometimes.
I am not sure if I've put myself in a primary hypogonadal situation. The LH is never that high which is not consistent w/primary where the LH is usually like double digits. The other factor is that I had 2 different semen analyses when I was at my worst and still had reasonable numbers (relatively speaking...62 mill, 22 million). That might be due to the fact that it takes 90 days to produce sperm. However, I was told by 2 people over at the uro's office that my semen numbers are not horrible by any means. Plus, as I understand it, the Sertoli cells (90% of the testes volume) are the mechanism for producing sperm, separate from Leydig T production. My nuts definitely don't look any smaller than when this happened, and if anything, Clomid "plumped" them up a little.
I've made an appt with Shippen. Unfortunately the earliest date is 7/17. I suppose I'll continue with this uro and voice the concern that they are basically ignoring Estradiol and verify in next bloodwork that E has risen (which I can almost guarantee is happening). I'm not sure how unhappy I'm going to be with them on next appt on 5/13, as I'm continually looking like a complainer when I voice that we are not looking at this in a 360 degree manner (vis a vi rising E, lack of discussion of supplements, & other issues that I'm continually told to not worry about). They probably perceive me as an impatient complainer, as I'm told to give things more time. The issue is more that we are not analyzing everything rather than giving it more time.
This is so horrible. Before those antibiotics, I was as healthy and virile as could be. I do see people with great success doing T/HCG combo therapy with E managed properly. I hope to get myself in good shape like others have even though I realize this is lifetime treatment.
Re: Is there anyone using T Cyp in conjunction with HCG
First, I am glad you are not doing anything that would allow any atrophy of the testicles like taking T replacement. Especially since you want to remain fertile.
What strikes me about your numbers is how high your E2 is even when T is low. Also I notice FSH was actually above the range after being on clomid. LH and FSH typically go up and down together. FSH can sometimes be a better indicator than LH because the half life of LH is short so you may not get an accurate reading on any single blood test. The fact that FSH went up substantially while on clomid and even went above range combined with having high E2 would indicate to me your problem is possibly related to the high E2 causing your hypothalmus to think you have enough T when you don't. Too bad no bloodwork was done before the switch to HCG. I think your uro may have been on the right track. Further evidence is you started to feel better while on the clomid.
Re: Is there anyone using T Cyp in conjunction with HCG
Quote:
Originally Posted by hayfarmer
First, I am glad you are not doing anything that would allow any atrophy of the testicles like taking T replacement. Especially since you want to remain fertile.
What strikes me about your numbers is how high your E2 is even when T is low. Also I notice FSH was actually above the range after being on clomid. LH and FSH typically go up and down together. FSH can sometimes be a better indicator than LH because the half life of LH is short so you may not get an accurate reading on any single blood test. The fact that FSH went up substantially while on clomid and even went above range combined with having high E2 would indicate to me your problem is possibly related to the high E2 causing your hypothalmus to think you have enough T when you don't. Too bad no bloodwork was done before the switch to HCG. I think your uro may have been on the right track. Further evidence is you started to feel better while on the clomid.
Let me make sure I understand what you're saying. Putting the reason aside for a second as to why my endocrine system is disrupted and looking at this at face value...are you saying that possibly the hypothalamus sort of refuses to make too much T since it since it doesn't want to exceed some set point of E2? I think what I was thinking when going to HCG is that I didn't see tremendous progress on Clomid and a guy I know who is a patient at the same practice liked HCG much better so I opted for that. Interestingly, approximately the 4th week on Clomid (right after the bloodwork), I got an erection in the morning when I was working and the beginnings of some nighttime erections (this was after the bloodwork). I think when I met with the doc a few days later, I was probably disappointed/frustrated in the modest increase in T and this moved my thinking to trying HCG under the theory that HCG is essentially LH, so maybe boosting LH could get quicker results with my T since the 1st test only yield 3.6. At that time, I was not tuned into E2 as much and its implications and now I'm assuming that I'm elevating E2 and I'm worried, as I'm dealing with sort of an "anti-AI" type practice. I don't know what the bloodwork will yield in a week, but I may use this doc up to the time I see Shippen and continue HCG in lower doses (or Clomid) just to get myself some form of treatment and then start fresh with Shippen. As a side note, there is a guy in another form who performed similar to me with relatively short-term Clomid and asked his uro to let him continue with on low-dose therapy. I followed up with him and apparently, he got his low 300s T nos into 400s/500ish and his E2 under control and he say symptomatically he feels fine even though his T is low/normal. He was the one who said Shippen has documented that Clomid can have results on a longer term basis. I suppose theoretically speaking, if somehow Clomid could yield 600s T and the E2 could be managed, there could be a lot of symptomatic relief. I'm going to put all these observations down in my letter to Shippen. Thanks tremendousely for your input and any further ideas you might have are welcome.
Re: Is there anyone using T Cyp in conjunction with HCG
No, what I mean is this. The hypothalmus has receptors meant for T to bind to. That's how it senses what your T level is. The less receptors that are energized (by T binding) the more GnRH the hypothalmus will send to the pituitary. GnRH is what causes the pituitary to send LH to the testes. The problem is that E2 and T are very similar on a molecular basis. So, the E2 is also able to bind the the receptors meant for T. When this happens it tricks the hypothalmus into sending out less GnRH and hence results in less T made by the testes. My understanding of clomid is that it binds to the receptors in the hypothalmus but does not energize them. So it essentially blocks the E2 from binding. This has the effect of more GnRH, more LH, and more T. It may take some time for the hypothalmus and/or testes to respond if they have been shut down for a while which is why you may not get an immediate response.
I also wonder if arrimidex would work eventually by bringing down the E2 if the E2 really is the problem. I could be wrong but if right using clomid or the arrimidex would be better than HCG because LH is going to work better than HCG on the testes. HCG is very similar but not a duplicate of LH. The more natural components and hormones you can keep the better. Believe me, replacement is a difficult balancing act so anytime you can keep your body making a hormone it's better. By using HCG you bypass both the hypothalmus and the pituitary. By using clomid you force both of them to do their job.
Re: Is there anyone using T Cyp in conjunction with HCG
OK. Gotcha. Good explanation on the hypothalamus and how Clomid works. Yeah, maybe I screwed up by getting frustrated and moving to HCG. I suppose Clomid doesn't cause that sharp spike in E2 like HCG at certain doses does. I just kept reading that people felt better on HCG. I suppose the uro is agreeable to either one at this point. I had understood that most people that succeed on Clomid would've seen better T boosting results than I in a similar timeframe, so I though I essentially "failed" this de facto Clomid test. However, who knows, maybe it would've gone to the 500/600s with more time. I suppose it still isn't too late. I can see what another blood panel yields and switch if I want to. Your point is well taken about letting most of the endocrine system do its job...the fact that Clomid works at the highest level of the feedback loop so thus, keeps the pituitary doing its job vs HCG which essentially replaces the pituitary's LH signal (one level further in the endocrine system). I suppose what frustrated me is getting a result and hearing that only a minority of people feel incredible symptomatic relief on Clomid. However, maybe this is why Drs. Crisler/Shippen both designed a Clomid low dose therapy with AIs and other drugs to assist with symptomatic relief.
Re: Is there anyone using T Cyp in conjunction with HCG
I did further research and feel that I have gotten to the bottom of what happened in my particular case. One thing that is relevant that I didn't bring up is that I taken something called Cholestoff which contains plant sterols. That and the antibiotic were the only things I took (other than fish oil which doesn't impact this analysis). As it turns out, antibiotics (such as tetracycline) are known to slow down the P450 system in the liver, which is responsible for excreting estrogen. So, that was bad enough. A plant sterol (Cholestoff) which has an estrogenizing effect probably compounded the problem. (I had no idea Cholestoff worked in this way...ie. slowing down DHT & thus tipping the scales in favor of Estradiol. I had used the brand from a reputable company, Nature Made, to bring my LDL down a little.)
The homeostastis of the T:E ratio was disrupted and now, as you point out in your last post, not enough stimulation is happening at the hypothalamus level vis a vi GnRH. I agree with you that Arimidex or zinc or some estrogen blocker should be part of the solution.
Maybe since my axis has never really been shut down entirely, we can use an estrogen blocker with other supplements to deal with this problem. I am also trying to do things on my own in the meantime...getting to my ideal BMI weight (6'2", 200lbs), high intensity weightlifting to boost T, clean diet, vitamins.
Last edited by Administrator; 05-07-2013 at 11:22 AM.
Re: Is there anyone using T Cyp in conjunction with HCG
I think you're on to something then. A good Dr. in this area will hopefully get you back to normal. Hopefully nothing permanent but even if so there are treatments that should get your T levels back up.
Re: Is there anyone using T Cyp in conjunction with HCG
Quote:
Originally Posted by hayfarmer
I think you're on to something then. A good Dr. in this area will hopefully get you back to normal. Hopefully nothing permanent but even if so there are treatments that should get your T levels back up.
Hi Hayfarmer,
I received the blood work results from last week. Keep in mind this was after the switchover to HCG for only a 2 week period. I was originally prescribed 4500iu/week but lowered it to 3000iu/week, as I was concerned about such a high dosage.
I also ordered these addl tests:
Vit D=15 (30-100) (abysmally low)
Vit B12= 542 (200-1100)
DHEA=94 (61-1636) - This supports my adrenal fatigue theory as elevated cortisol will lower DHEA, the precursor to T production. Shippen sometimes prescribes DHEA supplementation when appropriate from what I understand.
DHT (not yet available but awaiting results)
The doctor was pleased with the increase in T, especially given the low starting point 2 1/2 mos. ago. He finally prescribed Arimidex and told me it would be a 1mg daily dose. I told him I wasn't comfortable with such a high dose and would split the pills. He also told me to use 1,500iu EOD of HCG even though I had mentioned I lowered my dose before the blood work. They don't know that I'm moving over to Dr Shippen in a couple of months. I was able to include these results to Dr Shippen in my letter/materials that I overnighted to him.
At this point, I was going to run the following by you. I figured I might use the HCG & Arimidex in the following way in the interim until I am seeing Dr Shippen. I also don't know whether he will require a Clomid or HCG challenge since I have effectively already done those at pretty close to the dosages he prescribes.
HCG - either 2000iu or 2500iu weekly (either split 3 days or 5 days @4-500/d)
Arimidex - 1/2 pill EOD (monitoring symptoms carefully)
Vit D supplementation - important yet still figuring how much to dose
Fish oil - to help with SHBG which was formerly great at 22, now at 35 which I'd like a little lower
My philosophy is that I don't feel comfortable overdoing these medications. If 3000iu HCG yielded a mid-500s T level, I figure 2000-2500 with an AI might maintain the same level, as there is theoretically a boost in T with less aromatization. Is that thinking correct? Short of being instructed to get blood work at least 3 weeks before my mid-July appt, I'm not sure what Dr Shippen might want me to do in the interim, although maybe he will review my materials and then come up with a plan? Any thoughts would be appreciated. Thanks.
Re: Is there anyone using T Cyp in conjunction with HCG
I agree with you your doctor is dosing you too high. Ok for a brief period but I would worry about desensitization. I would not take more than 500 iu per day of HCG. With HCG the rule is the lowest dose that works. I think the AI may work better than anyone expects. You dose of 1/2 pill EOD may even be a bit too high. I started out taking 1/2 two times a week and once I got my levels right I went down to 1/2 pill once and 1/4 three days later. Now I don't take any and my E2 stays good. Maybe you should take 1/2 pill two times a week until you see Dr. Shippen. By the way, too much HCG will also spike E2.
I think your plan to continue the HCG (at a lower dose) and start the arrimidex until you see Dr. Shippen sounds fine. Be careful about too much arrmidex since you have a while to go before you will test your levels. Do you feel better with the higher T level? If not it could be because E2 is still too high and T is still a bit low.
On the vitamin D3 I take 20,000 iu three times a week. You can take too much so you need to monitor you levels. Pure encapsulations has a 10,000 iu cap if you're interested in that. They can be hard to find in stores in that strength.
When I first went to Dr. Shippen he sent me instructions on what to do before the first visit along with a blood test order. That way he had everything he needed on the first visit to begin treatment.
The Following User Says Thank You to hayfarmer For This Useful Post: davie12 (05-16-2013)
Re: Is there anyone using T Cyp in conjunction with HCG
Thanks. That's great input. I was particularly interested in your dosage philosophy on Arimidex and will follow what you say to be safe...1/2 pill twice/week to get started. I can monitor symptomatic improvement along the way. That's great that you have weaned yourself off of the drug. I have also heard of others successfully doing that.
And the 500iu/day HCG max is something I've seen referred to many times so I'll follow that.
Incidentally, you might find this point interesting. From what I understand, DHEA supplementation has an additive effect to naturally produced DHEA and doesn't shut down the endocrine system (as other exogenous substances do). Perhaps that's why I see Dr Shippen use that for some people when appropriate. I pointed out the high cortisol and low DHEA on different blood tests I sent him. Perhaps some DHEA could further boost testosterone production.
Re: Is there anyone using T Cyp in conjunction with HCG 
