question from a user
AlphaMD's Answer
Hey there, we had a few people review this since you were pretty clear.
Let's break this down a bit. First, your labs have nothing that jump out at our providers as needing treatment other than the the testosterone values which could mark hypogonadism or relative hypogonadism based on Sx.
As far as goals go, that makes perfect sense. Let's look at the protocol. If you would like to do daily, that is just fine, though there's not much reason to do daily outside of personal preference or because you find you have too much transfer to Estrogen by doing it 2-3 times a week.
About the values, this is where we would suggest something different. 5mg of Testosterone daily is only 35mg of Testosterone weekly. On any level of Testosterone you will have natural suppression, it is not something you can just add a small bit to like you would a medication. For any value of Testosterone you need to overcome that level of suppression that you expect to experience with it's dose. For someone like yourself who does look to have decent hormonal function, but is experiencing relative hypogonadal symptoms this is moreso the case.
One might assume that adding HCG would maintain function and fertility, and that is true about the active fertility but only partially true about function. Imagine your testes as a factory. Taking testosterone shuts the factory down. Taking HCG opens the factory back up, but only allows in half the workers as previously. The HCG isn't going to counter the suppression you experience the way one might hope.
That said, HCG does improve production and fertility. So let's look at the addition of FSH. This does not add anything to the goals of traditional TRT. It does not increase Testosterone production or testosterone related teste function. It specifically targets spermatic production, and it will certainly increase your sperm count. There is nothing wrong with doing this, but unless you are actively trying to have a child *right now* or within 6 months, this really won't impact the effectiveness of your TRT nor the visual cosmetics of your testes while running Testosterone & HCG.
So we have a few suggestions for you, and some options:
-Following this exact regimen style, you would need to increase your Testosterone dose to ensure you don't have less total T than when you started due to suppression.
-Altering this regimen to not include FSH unless you are super sure you're trying to have a child now or within 6 months, because (at least here in the USA) FSH like this is incredibly expensive & it really isn't doing much for your treatment. We would even go sofar as to say unless you are trying to conceive you don't need the HCG right now & are free to start it ~6 months out from when you plan on doing so. But if you wanted to be good at a moment's notice or wanted the cosmetic benefit then keep the HCG.
-If you are keeping HCG for fertility, and are actively looking to have a child, you should shoot for 1500 weekly rather than 700. If it's not active, then this is fine.
-Finally, your hormonal production looks good enough at a glance to suggest relative hypogonadism. For people like you Enclomiphene may actually be the right answer. It boosts your natural production, and thus for people who have relative hypogonadism with higher levels of production, this can work really well for them. It doesn't work as well for people who are truly low on production because +20% of nothing is still nothing. It also has the benefit of not impacting fertility and function as much as pure Testosterone injections do.
We'd also say you really don't need to spend that much money at all to get the results you want. The human body sometimes prefers a less is more approach to work just fine.
I hope that helps and we answered everything from multiple angles!
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