Human chorionic gonadotropin

Human chorionic gonadotropin

Postby MikeDCross » Fri Apr 08, 2016 10:02 am

Seems like my time for asking probably dump questions.....

My pituitary is not working, so it is not generating the LH/FSH which my testes need to generate T.

Now a lot of USA sites recommend giving Human chorionic gonadotropin, as it acts like LH/FSH, which enables the testes to continue producing T naturally.

Do you know why GP endro's prescribe T and not Human chorionic gonadotropin, as doing it naturally seems to make more sense...but my consultant is very anti Human chorionic gonadotropin...and I have yet to understand why.
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Re: Human chorionic gonadotropin

Postby Carl » Fri Apr 08, 2016 1:00 pm

I've asked mine this question, I'll let you know what he says....if anything :)
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Re: Human chorionic gonadotropin

Postby Carl » Fri Apr 08, 2016 1:55 pm

Seemingly it may not be something the NHS funds and UK medicine questions the efficacy of hCG too.

I am always a bit hesitant with anything to do with T and the American point of view, they do seem a bit obsessed with TRT - but I guess it will take a few more trials and medical studies before the UK adopts hCG, if they ever do.
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Re: Human chorionic gonadotropin

Postby MikeDCross » Sun Sep 25, 2016 12:45 pm

I'm now more confused, I was talking to my haematologist, who said he would prescribe it, as it is most effective than T, and cheaper; but my endro consultant says no, as there is no evidence, yet I found this on the web >> http://www.northoftyneapc.nhs.uk/wp-con ... v-2013.pdf <<.

I'd hope that there was 1 answer for everyone, but that does not appear to be the case.
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Re: Human chorionic gonadotropin

Postby Carl » Sun Sep 25, 2016 2:04 pm

I got this reply about HCG recently.....I don't think the medical community have entirely decided abiut HCG yet.....

Secondary hypogonadism can be treated with testosterone replacement therapy (TRT) if you aim to maintain sexual characteristics, increase in libido, muscle strength and muscle mass. However, TRT usually decreases the sperm count. Consequently, infertility is one of TRT possible adverse effects. Occasionally, TRT reduces testes size, especially if the testosterone dose is higher than ideal.

Therefore, if your goal is to improve fertility, TRT should not be used. Human chorionic gonadotropin (HCG), mimics the LH (a pituitary hormone that is low in secondary hypogonadism), and thus stimulates the testes to produce both testosterone and sperm. It is given by subcutaneous or intramuscular injections, 2 to 3 times weekly. HCG increases testosterone levels in a variable way, the increase is higher in younger than older men. The long term efficacy and safety for HCG for treating secondary hypogonadal men without fertility desire is not well established.

Both in the US and UK, TRT is by far the first choice treatment for secondary hypogonadism if fertility is not an issue. This is because TRT has a much more solid scientific evidence for efficacy and safety. In addition, TRT is less complex (usually requires 4 injections a year only instead of 100 injections annually needed for HCG) and is easier to reach the optimal dose.

And, if fertility becomes an issue, the response to HCG would not be affected by the previous TRT use.
In the UK and the US, experts from respected institutions advocate against HCG treatment for hypogonadal men without fertility desire. The off-label use of HCG in these patients is occasionally (but increasingly) prescribed to “treat” significant testes shrinkage or to maintain sperm and testosterone production on patients on TRT or as a sole medication. This unlicensed use is more common in the US, but the drug is also available in the UK. At this stage, I would definitely choose TRT if the main goal is to improve sexual health, mood and muscle strength and would wait for more evidence in benefits and risks related to HCG.
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Re: Human chorionic gonadotropin

Postby MikeDCross » Mon Sep 26, 2016 12:28 pm

Carl,

I'm way too old to be thinking about extending my family, but being totally honest, I would like my testes to return to normal size.

After testing T injections for 6 months, we abandoned that approach as the side effects were worrying; having had no treatment for 7 months, I am 100% sure that no treatment is not an option; my consultant wants to try t-gels, as it *may* work. If the Gel does not work, then I need a 3rd option, and HCG may be the only way.

M
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Re: Human chorionic gonadotropin

Postby Carl » Mon Sep 26, 2016 6:30 pm

At least with the T-gels you can take a very low dose of T to see what effect it has on your blood levels. You need to keep T in range for your age to keep bones healthy. Hope the docs can come up with a resolution for you.....
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Re: Human chorionic gonadotropin

Postby MikeDCross » Fri Oct 07, 2016 3:38 pm

Carl,

My GP says we try the gel for a while and see how effective it is, and how I tolerate it; and if this does not work, he may consider hcg.... there just does not seem to be a simple answer, and I like simple.

Thanks
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