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question from a user

Assuming cost isn’t an issue, what’s the best dose of HCG as a supplement to TRT? I’ve seen as low as 500iu weekly and as high as a few thousand. What are the factors to consider when dosing. Aromatization? Ball size? How someone feels?

AlphaMD's Answer

"Best" dose is always individual, but here is a quote from a frequently cited study that will help explain things:

https://pubmed.ncbi.nlm.nih.gov/30159241/
"In healthy eugonadal men selected to undergo TRT it was shown that their intratesticular testosterone levels dropped by 94%. However, in those who received 250 IU SC every other day along with TRT their intratesticular testosterone levels only dropped 7%. Additionally, in men who received TRT and 500 IU of hCG every other day an increase in intratesticular testosterone by 26% was observed."

So, this basically means that for men on TRT, the addition of 750IU hCG per week, the intratesticular testosterone (ITT) was pretty close to baseline. Doubling this dose led to better fertility markers than baseline by 26%.

So many clinics have simplified this to:

  • 500IU for maintenance of testicular volume, maintain near normal fertility

  • 1000IU for reversal of prior testicular atrophy, greater than normal fertility

  • 1500IU for men actively trying to conceive

Higher doses have been studied, though without any evidence of greater returns (higher doses above 1500IU/wk do not seem to provide additional benefits despite much higher side effects)

hCG aromatizes at a significantly higher rate than TRT, so it is not uncommon for men on higher doses to require an aromatase inhibitor for symptomatic control.

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