The best HCG dosage while on course

[liftsiron]

Posted by Mr. Incredible


The best HCG dosage while on course answered
Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression

Andrea D. Coviello, Alvin M. Matsumoto, William J. Bremner, Karen L. Herbst, John K. Amory, Bradley D. Anawalt, Paul R. Sutton, William W. Wright, Terry R. Brown, Xiaohua Yan, Barry R. Zirkin and Jonathan P. Jarow
Center for Research in Reproduction and Contraception, Geriatric Research Education and Clinical Center, Veteran Affairs Puget Sound Health Care System (A.M.M.), and Department of Medicine, University of Washington School of Medicine (A.D.C., W.J.B., J.K.A., B.D.A., P.R.S.), Seattle, Washington 98195; Department of Medicine, Charles R. Drew University (K.L.H.), Los Angeles, California 90059; Department of Urology, Johns Hopkins University School of Medicine (X.Y., J.P.J.), Baltimore, Maryland 21287; and Division of Reproductive Biology, Department of Biochemistry and Molecular Biology Johns Hopkins University School of Public Health (W.W.W., T.R.B., X.Y., B.R.Z., J.P.J.), Baltimore, Maryland 21205

Address all correspondence and requests for reprints to: Dr. Andrea D. Coviello, Feinberg School of Medicine, Northwestern University, Tarry 15-751, 303 East Chicago Avenue, Chicago, Illinois 60611-3008. E-mail: a-coviello@northwestern.edu.

In previous studies of testicular biopsy tissue from healthy men, intratesticular testosterone (ITT) has been shown to be much higher than serum testosterone (T), suggesting that high ITT is needed relative to serum T for normal spermatogenesis in men. However, the quantitative relationship between ITT and spermatogenesis is not known. To begin to address this issue experimentally, we determined the dose-response relationship between human chorionic gonadotropin (hCG) and ITT to ascertain the minimum dose needed to maintain ITT in the normal range. Twenty-nine men with normal reproductive physiology were randomized to receive 200 mg T enanthate weekly in combination with either saline placebo or 125, 250, or 500 IU hCG every other day for 3 wk. ITT was assessed in testicular fluid obtained by percutaneous fine needle aspiration at baseline and at the end of treatment. Baseline serum T (14.1 nmol/liter) was 1.2% of ITT (1174 nmol/liter). LH and FSH were profoundly suppressed to 5% and 3% of baseline, respectively, and ITT was suppressed by 94% (1234 to 72 nmol/liter) in the T enanthate/placebo group. ITT increased linearly with increasing hCG dose (P < 0.001). Posttreatment ITT was 25% less than baseline in the 125 IU hCG group, 7% less than baseline in the 250 IU hCG group, and 26% greater than baseline in the 500 IU hCG group. These results demonstrate that relatively low dose hCG maintains ITT within the normal range in healthy men with gonadotropin suppression. Extensions of this study will allow determination of the ITT concentration threshold required to maintain spermatogenesis in man.


full study;
Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression -- Coviello et al. 90 (5): 2595 -- Journal of Clinical Endocrinology & Metabolism

[Ms.Wetback]

Call me stupid............but which one worked best, the 125, 250 or 500iu ???
I took it as 250iu.

[liftsiron]

Call me stupid............but which one worked best, the 125, 250 or 500iu ???
I took it as 250iu.

The 500ius increased ITT 26% greater than baseline. 125ius 26% less than baseline and 250ius 7% less than baseline. So it would seem that 500ius would be the ideal dose the way I read it anyhow.

[Ms.Wetback]

The 500ius increased ITT 26% greater than baseline. 125ius 26% less than baseline and 250ius 7% less than baseline. So it would seem that 500ius would be the ideal dose the way I read it anyhow.

I read this

"Posttreatment ITT was 25% less than baseline in the 125 IU hCG group, 7% less than baseline in the 250 IU hCG group, and 26% greater than baseline in the 500 IU hCG group."

as 250iu got as close to baseline (ie:normal homeostasis) as could be expected. 125iu was under-dosed and 500 was over-dosed.

Help me out here...............

[liftsiron]

I read this as 250iu got as close to baseline (ie:normal homeostasis) as could be expected. 125iu was under-dosed and 500 was over-dosed.

Help me out here...............

You got it 250ius was very close to baseline, but imo 26% greater than with 500ius would be more desired imo.

[Ms.Wetback]

You got it 250ius was very close to baseline, but imo 26% greater than with 500ius would be more desired imo.

OK whew...............I am glad I read it right.

Just curious why would you want elevated numbers as opposed to baseline ?? Chance of inducing gyno with that.

[liftsiron]

OK whew...............I am glad I read it right.

Just curious why would you want elevated numbers as opposed to baseline ?? Chance of inducing gyno with that.

lol, that's just me, personally I never use hcg as I always stay on at the very least a high TRT dose. My testes don't shrink even at high dose, I'm not sure why, I can remember years ago they did on cycle. I think maybe because I hit novladex often?

[Deacon]

personally I think HCG while on cycle is a waste

[JabsDD]

personally I think HCG while on cycle is a waste

Couldn't agree more!

[Freezerdude]

Couldn't agree more!

Could you please explain you theory on this? While I'm on cycle and experiencing testicular atrophy I'd much rather use HCG if nothing else for cosmetic apperance..
I mean wouldn't you rather be toting around a couple walnuts or a couple raisins?

[liftsiron]

Could you please explain you theory on this? While I'm on cycle and experiencing testicular atrophy I'd much rather use HCG if nothing else for cosmetic apperance..
I mean wouldn't you rather be toting around a couple walnuts or a couple raisins?

If you experience considerable shrinking of the testes during cycle, I personally would run the hcg throughout the cycle to prevent this.

[Freezerdude]

I usally don't shrink unless I go over 600mg of test then I run HCG entire cycle.

[IxxTapouTxxI]

And your opinions on running HCG for PCT?

[Freezerdude]

See if this will clear things up a little..

By John Crisler, DO

In my paper ?€œMy Current Best Thoughts on How to Administer TRT for Men?€?, published in A4M?€™s 2004/5 Anti-Aging Clinical Protocols, I introduced a new protocol where small doses of Human Chorionic Gonadotrophin (HCG) are regularly added to traditional TRT (either weekly IM testosterone cypionate or daily cream/gel). The reasons and benefits of this protocol are as follows, along with a new improvement I wish to share:

Any physician who administers TRT will, within the first few months of doing so, field complaints from their patients because they are now experiencing troubling testicular atrophy. Irrespective of the numerous and abundant benefits of TRT, men never enjoy seeing their genitals shrinking! Testicular atrophy occurs because the depressed LH level, secondary to the HPTA suppression TRT induces, no longer supports them. It is well known that HCG?€”a Luteinizing Hormone (LH) analog?€”will effectively, and dramatically, restore the testicles to previous form and function. It accomplishes this due to shared moiety between the alpha subunits of both hormones.

So, that satisfies an aesthetic consideration which should not be ignored. Now let?€™s delve into the pharmacodynamics of the TRT medications. For those employing injectable
testosterone cypionate, the cypionate ester provides a 5-8 day half-life, depending upon the specific metabolism, activity level, and overall health of the patient. It is now well-established that appropriate TRT using IM injections must be dosed at weekly intervals, in order to avoid seating the patient on a hormonal, and emotional, roller coaster. Adding in some HCG toward the end of the weekly ?€œcycle?€? compensates for the drop in serum androgen levels by the half-life of the cypionate ester. Certainly the body thrives on regularity, and supplementing the TRT with endogenous testosterone production at just the right time?€”without inappropriately raising androgen OR estrogen (more on that later)?€”approximates the excellent performance stability of transdermal testosterone delivery systems for those who, for whatever reason or reasons, prefer test cyp.

But there?€™s another metabolic reason to employ this protocol. The P450 Side Chain Cleavage enzyme, which converts CHOL into pregnenolone at the initiation of all three metabolic pathways CHOL serves as precursor (the sex hormones, glucocorticoids and mineralcorticoids), is actively stimulated, or depressed, by LH concentrations. It is intuitively consistent that during conditions of lowered testosterone levels, commensurate increases in LH production would serve to stimulate this conversion from CHOL into these pathways, thereby feeding more raw material for increased hormone production. And vice versa. Thus the addition of HCG (which also stimulates the P450scc enzyme) helps restore a more natural balance of the hormones within this pathway in patients who are entirely, or even partially, HPTA-suppressed.

It is important that no more than 500IU of HCG be administered on any given day. There is only just so much stimulation possible, and exceeding that not only is wasteful, doing so has important negative consequences. Higher doses overly stimulate testicular aromatase, which inappropriately raises estrogen levels, and brings on the detrimental effects of same. It also causes Leydig cell desentization to LH, and we are therefore inducing primary hypogonadism while perhaps treating secondary hypogonadism. 250IU QD is an effective, and safe, dose. After all, we are merely replacing that which is lost to inhibition.

In my previous report I recommended 250IU of HCG twice per week for all TRT patients, taken the day of, along with the day before, the weekly test cyp injection. After looking at countless lab printouts, listening to subjective reports from patients, and learning more about HCG, I am now shifting that regimen forward one day. In other words, my test cyp TRT patients now take their HCG at 250IU two days before, as well as the day immediately previous to, their IM shot. All administer their HCG subcutaneously, and dosage may be adjusted as necessary (I have yet to see more than 350IU per dose required).

I made this change after realizing that the previous HCG protocol was boosting serum testosterone levels too much, as the test cyp serum concentrations rise, approaching its peak at roughly the 72 hour mark. The original goal of supporting serum androgen levels with HCG had overshot its mark.

Those TRT patients who prefer a transdermal testosterone, or even testosterone pellets (although I am not in favor of same), take their HCG every third day. They needn?€™t concern themselves with diminishing serum androgen levels from their testosterone delivery system. These patients will, of course, notice an increase in serum androgen levels above baseline.

While HCG, as sole TRT, is still considered treatment of choice for hypogonadotrophic hypogonadism by many , my experience is that it just does not bring the same subjective benefits as pure testosterone delivery systems do?€”even when similar serum androgen levels are produced from comparable baseline values. However, supplementing the more ?€œtraditional?€? TRT of transdermal, or injected, testosterone with HCG stabilizes serum levels, prevents testicular atrophy, helps rebalance expression of other hormones, and brings reports of greatly increased sense of well-being and libido. My patients absolutely love it. As time goes on, we are coming to appreciate HCG as a much more powerful--and wonderful--hormone than previously given credit.








Copyright John Crisler, DO 2004. This article may, in its entirety or in part, be reprinted and republished without permission, provided that credit is given to its author, with copyright notice and All Things Male - Center for Men's Health clearly displayed as source. Written permission from Dr. Crisler is required for all other uses.

[SLINSHADY]

HCG is NOT a waste during cycle, it will actually help by keeping your testes producing and its normal size. I've been on steriods for more than 5 years nonstop , blasting and crusing and my balls are huge thanks to 500ius of HCG weekly.