How Do I Use HCG with Anabolic Steroids?

[Bouncer]

Q: What’s the logic behind all the different timing and dosing of HCG ?? We hear taking it every day, every other day, every 3rd, 4th, or 5th day.

What about the dosing ? I hear to take it easy to prevent desensitizing the testes. With this you hear anywhere from 100 units to 250 units to play it safe. Others say anywhere from 500 to 2500 units at a time…Isn’t that a bit much ?

What about the length of time? I hear two clinics suggest 10 days; others say 3-5 weeks. Where does all this come from and who’s right?

A: Almost everything you hear or read will be anecdotal and therefore subject to no verification. Experiences with hCG while on TRT are posted. The use of hCG for PCT is only partly related to its use on TRT.

hCG while on TRT is used for two reasons. One reason is cosmetic. While on TRT it is not unusual and more often expected to have testicular atrophy. This is variable from individual to individual. The other reason is to act as a stimulus so the testicles do not shut down and therefore will be easier to initiate independent function after AAS cessation.

Desensitization is a potential problem with hCG. I do not think you will experience it with doses of 500IU or less 3X/week. Studies have used this dose for considerably long periods. In my patients when hCG was used while on AAS the dose was 1000IU every 3 days with one month on hCG followed by one month off hCG.

hCG for PCT involves additional concepts. This is the timing of hCG in relation to other medications for return of HPTA functionality. Under normal conditions the HPTA is a tightly coupled dynamic feedback loop. It is this coupling that has to be achieved after AAS cessation to return to normal. The analogy I use is the starting of a car by pushing it from behind. Alone the care will not start but with pushing the clutch can be popped and the car started.

After AAS cessation the secretion of LH is nil. It will not be able to initiate T production until a certain stimulus LH level is reached. Studies have shown that the time for this to occur can be lengthy. Thus the idea is to ‘push’ the testicles with hCG and get them started. Once T production is initiated the dependent variable is LH. If the hCG is withdrawn without adequate LH to couple with the testicles return of HPTA functionality will fail.

The increased production of LH is achieved by a dual action of clomiphene citrate and tamoxifen. Clomiphene is a mixed agonist/antagonist (SERM) at the estradiol receptor. Clomiphene will increase the secretion of LH by action at the hypothalamo-pituitary area. Clomiphene will cause an increase in LH and secondarily increases in T and estradiol. Estradiol has a negative feedback influence on the HPTA. Estradiol is 200X the inhibitory effect of T per molar basis. Normal serum levels are the following:

Testosterone: 3-10 ng/ml (10-35 nM/L)

Estradiol: 15-65 pg/ml (55-240 pmol/L)

Tamoxifen will counteract the effect of the estradiol. Once the hCG is withdrawn the LH, initiated by clomiphene and tamoxifen, will couple with the testicles and take over production of T by the testicles. The levels of LH to maintain and couple with the testicles are maintained by clomiphene and tamoxifen. Clomiphene is continued for 15 days while Tamoxifen is continued for 30 days.

In healthy adult men, circulating levels of testosterone have a distinct pattern, with increasing levels during sleep toward a maximum around the time of awakening and a decrease during the day. In PCT hCG is administered every other day. I suggest the same time each injection in an attempt to simulate this rhythm. This is purely empirical but I recommend hCG at bedtime (2200). Clomiphene is taken in divided doses of 50mg 2X/day.

[jack tors]

Goes against broscience when u read up on fertility clinic this is what I've seen

[blm]

I started following Dr Crisler's protocol for trt (opposed to my GP's) as well as his hcg protocol; during trt and cycles.

AN UPDATE TO THE CRISLER HCG PROTOCOL



By John Crisler, DO







In my paper “My 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 “cycle” 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 “traditional” 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.

[StanG]

I have found the following to be the most effective method for using HCG on cycle. Doing it this way has several benfits IMO.
1- It maintains leydig cell function the entire time you are on as opposed to allowing them to remain dormant then blasting with HCG to get them to resume function (ie: If you dont use it you will lose it).
2- It is at a low enough dose that you need not worry about leydig cell desensitization.
3- It is only pinned 2x/week so it doesnt have the inconvenience of daily pinning

250iu's- 2x/week for a total of 500iu's/week. This can be upped to 500iu's- 2x/week if still noticing some testicular atrophy and still be safe as far as leydig cell desensitization goes but 250iu's-2x/week works great for me and most I have spoken with.

[blm]

That's basically the protocol I posted in a nutshell. Except he is specific in terms of timing/day of administration.

[StanG]

I have found the following to be the most effective method for using HCG on cycle. Doing it this way has several benfits IMO.
1- It maintains leydig cell function the entire time you are on as opposed to allowing them to remain dormant then blasting with HCG to get them to resume function (ie: If you dont use it you will lose it).
2- It is at a low enough dose that you need not worry about leydig cell desensitization.
3- It is only pinned 2x/week so it doesnt have the inconvenience of daily pinning

250iu's- 2x/week for a total of 500iu's/week. This can be upped to 500iu's- 2x/week if still noticing some testicular atrophy and still be safe as far as leydig cell desensitization goes but 250iu's-2x/week works great for me and most I have spoken with.

Only thing I forgot to add is stopping HCG 3 days pre pct. HCG itself is supressive so you need to stop it pre pct IMO. 3 days pre pct I do my final hcg pin.

[StanG]

That's basically the protocol I posted in a nutshell. Except he is specific in terms of timing/day of administration.

I have heard Crisler is actually now advocating 100iu's of hcg /day from what I understand. At least that is what I have seen guys posting on anti aging forums as his latest recommendation. Have you heard of this?
I personally dont think that is practical, too damn inconvenient. The 250iu-2x/week works great for me.

[blm]

No, I haven't. It's not on his site. Though the posted protocol is a few years old, it's the only one he has posted. 2 days works great for me as well.

[jack tors]

Only thing I forgot to add is stopping HCG 3 days pre pct. HCG itself is supressive so you need to stop it pre pct IMO. 3 days pre pct I do my final hcg pin.

Yeah that's what we have been told but that's not what was suggested above or protocol I've read at fertility clinics. Seems like broscience I don't know?!?

[StanG]

Yeah that's what we have been told but that's not what was suggested above or protocol I've read at fertility clinics. Seems like broscience I don't know?!?

Yeah I dont know. It would make sense that it is. Being a LH mimetic that is way more potent than LH I can see where it would make sense that it is in fact supressive.
Either way I am pretty comfortable with stopping 3 days pre pct based on my results.
HCG on cycle is probably the second biggest advancement I have encountered in my 20+ years of AAS use, the first being the incorporation of using an ai on cycle and managing estrogen in lieu of a serm which just selectively blocks it.

[TrapsBrah]

Bouncer I know you said you avoid hcg. Is it required for those that don't run test year round? 12-16 week long cycles.

[Bouncer]

Bouncer I know you said you avoid hcg. Is it required for those that don't run test year round? 12-16 week long cycles.

I'll let someone who knows more about hcg answer but from what I can tell people seem to use it for 12-16 week cycles. Blm, Stan?

[blm]

I recommend it. It makes recovery a lot easier.

[AllDay]

If one administers bi weekly testosterone injections, say Mon and Thurs, how would hcg then be administered? I've been on trt for almost three years now and I actually cycle for about 7 months out of the year. I've never incorporated hcg but I've noticed a lot of testicular atrophy so my interest in it has certainly been spiked. Any help is greatly appreciated.

[Chadd77]

If you're running cyp or enanthate why not pin once a week and use the protocol above?

I may try this my next time around. I'm 4 weeks into my pct. Can't wait until my boys get back to where they need to be.