I have been on my TRT lite protocol now for a little over a year. I can safely say that increasing my levels of testosterone & estradiol has increased my quality of life and probably also my health. While it is not “life-changing” by any means, overall I feel it to be quite a strong net benefit to multiple aspects of my life.

Goals

I am a fan of running experiments constantly – in all domains of life. Even though 95% of my experiments are usually failures (i.e., I stop the intervention), the remaining 5% easily make up for the rest.

A couple of years ago, I was on TRT for quite some time. My results were underwhelming. In short, other than some decreased sleep needs (about one hour per day less), some facial aging, a greater ability to put on muscle, perhaps an increased drive, and a slightly puffy face I have not noticed much. However, back then my leptin levels were abysmally low, which may have masked many of the neurocognitive effects of increased levels of sex hormones. I discuss my first experience with TRT in more detail here.

Given that my leptin levels are now taken care of, I wanted to give TRT another chance. With this experiment, my primary goal was to experience what it “feels” like to walk around with higher levels of testosterone and estradiol.

Baseline values

My baseline values were quite decent.

• Testosterone: 630ng/dl (range: 350-836)
• Bioavailable testosterone: 3.029 ng/ml (range: 1.260-4.110)
• SHBG: 48.20 nmol/l (range: 16.00-60.00)
• Estradiol: 21.2 pg/ml (range: 27.1-52.2)
• LH: 5.8 mU/ml (range: 1.7-8.6)
• FSH: 2.01 mU/ml (range: 1.50-12.40)

Despite these levels though, my libido and emotionality were fairly low, which I suspect was (partly) due to the low levels of estradiol. My E2 levels are presumably low because of my little body fat, roughly 9-10%. Fat tissue expresses aromatase, which converts testosterone to estradiol and, all else being equal, the less body fat someone has, the lower the estradiol.

A note on estradiol

I recently did a Reddit deep-dive on anecdotes for low vs. high estradiol levels in men who are on exogenous testosterone (and who often manipulate estrogen levels pharmacologically with aromatase inhibitors). Out of over 100 anecdotal reports of men who have experienced states of both low and high estradiol, the common theme is that, with high estradiol, men report feeling more “excitatory” – stronger emotions, more anxiety, greater joy, more “bubbly”, more prone to crying during sad movies, higher libido, etc.

Conversely, in states of low estradiol men report to be more “flat”, rational, apathetic, and anhedonic.

Anecdotally, a friend of mine, who is on TRT, claims that when his estradiol runs high there is a lot going on in his emotional universe, and if he then takes low doses of aromatase inhibitors the excitement and anxiety turn to low levels and he becomes more rational within the span of a couple of days.

It is partly for this reason that women generally feel more and stronger emotions than men. Neurobiologically speaking, women’s brains are more capable of generating emotions because, firstly, they are wired differently (due to genetics + early life influences of hormones) and, secondly, women have higher levels of ADH, oxytocin, and estradiol (and perhaps other circulating factors). I am quite certain that differences in estradiol levels are not to be neglected.

This may be also one reason why women are, on average, more empathetic than men because empathy is a function of a brain’s capacity to generate deep emotions. I discuss this in more detail when I discuss my experience with SSRIs, a class of drugs that often decreases levels of empathy.

Essentially, my goal with my second run of TRT was to experience what life is like with about twice as much estradiol.

Temporarily I also applied a small dose of Estrogel to my forearms and my face. Of note, microdoses of topical estradiol are, in my opinion, one of the best topical anti-aging skin treatments blowing tretinoin out of the water.

Already on day two, I felt much better. In fact, I was surprised by the rapidity of the effects. Anyway, it has now been over 15 months, and elevating my estradiol levels to the high normal range, was one of the most powerful interventions I ever did.

My experience

I was always fascinated by hormones. Unlike most medications, which usually target a single pathway, hormone treatments are whole-body treatments. For example, adding testosterone to the system will change the expression of hundreds of genes in pretty much any organ, from muscle, skin, brain, immune cells, liver cells, etc. I discuss the unparalleled power of hormones in more detail here.

My starting dose was 100mg of testosterone cypionate per week, split into daily injections of 15mg per day.

I noticed effects quite early on. Already after a couple of days, I felt decently more awake in the morning. Furthermore, on day four it occurred to me that I can work for longer on cognitively demanding tasks without needing breaks.

After about two weeks, I noticed an unmistakable low-level euphoria and a particularly good mood that lasted for a couple of days. I also felt a distinct increase in calmness, mood, and motivation, quite similar to the initial periods of SAM-e supplementation. I suspect that these effects may be in part due to an early increase in dopamine levels. Overall, I just felt remarkably “well”. This is probably what people refer to as the “honeymoon period”.

On the physical side, I noticed an increase in body odor. Normally, I can’t smell my body odor, not even after physical exercise, but on testosterone, I started to smell bad even if I did not exercise. I needed to apply deodorant multiple times per day.

I also noticed an increase in the visibility of my shoulder veins, which were very prominent in the gym. Also, my muscles started to look fuller. These effects would have probably not been as prominent had I not had so little body fat.

Throughout my first month, I was generally more awake and motivated than normal, and I remained cognitively sharp for most of the day. I also felt more “present”. Furthermore, my emotions felt “enhanced”. For example, I was rejected romantically by someone who I really liked, and the ensuing sadness was quite strong – from experience, I can say much stronger than when I was not on TRT.

After one month on 15mg of testosterone per day, I did a blood test. Surprisingly, I was not (yet) suppressed. My LH was 3.15 mU/ml and my total testosterone was about 850ng/dl.

Anecdotally, if testosterone is injected daily, LH and FSH levels are less affected compared to weekly or twice weekly injections, even if the total cumulative dosage remains the same. Also anecdotally, people report lower estrogen levels and a lesser effect on SHBG levels with daily injections.

What surprised me the most was that I had almost zero water retention. However, I suspect that this is due to having little body fat, and consequently a lesser increase in estradiol, which drives most of the water retention.

Because my testicles had shrunk a bit, I decided to add 50 IU of HcG per day after one month. I stayed on this protocol (15mg testosterone cypionate per day + 50 IU HcG) for one more month before I did another blood test.

• Total testosterone: 1020 ng/dl (range: 350-836)
• Bioavailable testosterone: 6.498 ng/ml (range: 1.260-4.110)
• SHBG: 26.2 nmol/l (range: 16.00-60.00)
• Estradiol: 42.5 pg/ml (range: 27.1-52.2)
• LH: < 0.3 mU/ml (range: 1.7-8.6)
• FSH: < 0.3 mU/ml (range: 1.50-12.40)

So, my estradiol effectively doubled and my total testosterone increased from 730ng/dl to slightly over 1000 ng/dl. However, these changes are misleading. Firstly, my SHBG levels were almost halved, which means more free testosterone (reflected in a doubling of bioavailable testosterone and estradiol). Secondly, on TRT there are no circadian fluctuations, meaning that my testosterone levels remain high all day long vs. only high in the morning hours. So a 600ng/dl on TRT is effectively much higher than a 600ng/dl for someone not on TRT.

I now want to comment on a couple of changes I noticed.

Energy levels

There was a definite increase in energy levels during the first month. Usually, I can only work for about two to three hours per day on cognitively demanding tasks but on TRT, I felt that this time had doubled. I also noticed an increased ability to deal with sleep deprivation. Sometimes I only slept for 5-6 hours but I still felt that I was firing on all cylinders, something that I normally do not do when I am sleep-deprived.

However, because I stopped TRT quite early, it is hard to say whether these effects would have persisted. According to many anecdotes, many of the effects on energy, motivation, and drive eventually decline again though they are very pronounced during the first couple of months. In fact, it seems that many are permanently chasing the “honeymoon phase” by constantly raising their dosage.

Libido

My libido did not change much until I added HCG about 1 month in. After adding in the HCG (50IU per day), I noticed a decent increase in sexual thoughts and I also frequently dreamt of having sex. I also became interested in “short-term” encounters in a way I had not before and I let myself become much more promiscuous than I would like.

Just like hunger, I find excessive libido to be distracting. I did not come into this world to cater to my impulses.

Emotionality

I definitely felt more. It is hard to describe but let’s say one could quantify emotionality in the same way one can quantify IQ. If before my emotionality was 40, it was now 80.

Behavioral changes

Particularly interesting were the behavioral changes. Testosterone receptors are widely expressed in the central nervous system and sex hormones have effects on many brain sites, particularly in “emotional” centers of the brain.

On TRT, I noticed that I cared more about physical appearance. For example, I got more interested in fashion and I went out to buy some nice clothes on multiple occasions, something I would not normally do. I also noticed that I was bothered more by my height (174cm) than I normally am. Robert Sapolsky calls testosterone “the status-seeking hormone” and I guess that there is much to it.

I also noticed that I was looking others straight in the eye more and that I felt more dominant and “aggressive”. One of my brothers remarked, “I always loved about you that you are not aggressive but now you seem aggressive.”

Of note, it is hard to say which of these effects are caused by testosterone itself, and which are caused by its conversion to DHT or estradiol. For example, if the aromatization to estradiol is blocked, the “testosterone”-mediated increase in aggression and libido declines.

Physical changes

I had a distinct increase in body odor. In the past, I was told by women on multiple occasions that they liked the way I smell. I am sure that they would not have said that while I was on TRT.

After adding the HCG, my face became a little bloated, though I was the only one who noticed that and my friends did not. On the other hand, my voice became a little more resonant and slightly deeper (a drop in mean frequency by about 5 Hz – though my voice is still not deep by any means), which I suspect was mostly due to the increased water retention and increasing vocal fold mass. Overall, I retained about 1.5kg of additional water.

Despite not changing my caloric intake or exercise regime, I put on some muscle. Particularly my shoulders and delts seemed to grow. One friend told me that my neck had become thicker. I also noticed an increase in vascularity. (Note: I am occluding the veins with my other arm for an exaggerated effect. The picture was also taken at night, a time when I naturally vasodilate due to the melatonin secretion inducing my core temperature to drop. The small lesion on my median cubital vein is from a botched blood draw.)

After only two months on TRT, I noticed an increase in body hair. My beard and head hair grew faster and I had a slight increase in arm hair, new hairs grew on my chest, and I started to get very small dark hairs on my biceps (if one looks very closely), which I have never had before. I am still not hairy by any means but I prefer staying this way. Because virilizing changes are permanent, this was the primary reason I stopped TRT.

A note on testosterone and visual aging

During my first time on TRT, testosterone visibly aged me. After a year on TRT, others have commented that my face seems to have grown older by multiple years. My face still does not look old by any means and people consistently estimate my age at around 26-30 (depending on whether I carry a beard or not; I am 30) but I am sure that I would look younger had I not been on TRT.

This transition from boyish to more manly (which is not necessarily bad) may be in part explained by a redistribution of facial fat & a growth in facial musculature but it may also be in part because high levels of androgens drive the aging process.

To some extent, testosterone is like a peacock tail. High levels of testosterone help with signaling “good genes” in the short term.

It seems to me that “masculine” men (presumably with high levels of testosterone and DHT) peak early but less “masculine” men peak late, which may in part be a function of area-under-curve levels of testosterone and particularly DHT. One can readily see this “maturing” effect in bodybuilders, for example in this video showing the evolution of Chris Bumstead over time. Even though his physique is incredible, he looks much older than most other males his age.

One acquaintance of mine has aged by about a decade in only two years of bodybuilding. He is only 22 but looks like someone in his thirties. Conversely, some of my uncles look very young in their fifties, which, to me, seems to be related to their level of (visible) masculinity. The ones that have little body hair, overall look much younger compared to my more “masculine” uncles. I am sure there is a pattern.

Interestingly, another friend of mine, who has been on finasteride (a drug blocking the conversion of testosterone to the more androgenic dihydrotestosterone) for almost 20 years, looks about a decade younger than he is. He is now 42 but looks like someone in his early thirties. Article on finasteride here.

Summary

Overall I liked how TRT made me feel, and I particularly liked the many subtle behavioral changes, which would presumably compound over time. However, already after two months of use, I could see (permanent) virilizing changes, which, compounding over time, would presumably “age” me much faster than I would otherwise – perhaps not just visually. Thus, overall, this makes TRT not worth it for me, though it was a fun experiment.

Because I am not testosterone-deficient, hopping on the TRT bandwagon would, for me, be short-term thinking. Sure, I can feel and look better over a short period of time (perhaps a couple of months to a year or so) but would probably do net harm overall. The flame that burns twice as bright burns half as long.

I wonder whether combining TRT with a low dose of finasteride would give me the best of both worlds…or whether finasteride would detract more than what TRT adds in the neurocognitive and emotional realm. (Oh wait, I did that experiment! – Keep reading.)

Coming off

After my first time on TRT, I simply stopped injections, and I was back to baseline after 3-4 weeks. This time though I decided to run a mini-“post-cycle-therapy” for three weeks consisting of tamoxifen (5mg/day). Tamoxifen is classified as a selective estrogen receptor modulator but, unlike in bone and liver, in the brain, it is essentially an estrogen receptor blocker.

On tamoxifen, I felt a little “off” and a distinct state of “absentmindedness” and tiredness, which contrasted starkly with how I had felt on TRT. Also, the muscles underneath my left eye started to randomly twitch, something that I have also experienced on raloxifene, which I had experimented with a couple of years ago.

On tamoxifen, I had an unexpected increase in libido, which was particularly strong during the first week (with libido being even higher than on TRT). Furthermore, I experienced slight brain fog for the whole time I was on.  

Also, throughout my time on tamoxifen, I had a somewhat hard time getting out of bed. Normally, I wake up and I am immediately ready to go. However, on tamoxifen, I often was quite tired in the morning and I sometimes lay in bed for 15-30 minutes before finally getting up, which was related to a lack of vitality.

Also, during tamoxifen, I felt somewhat anhedonic and anergic and perhaps slightly depressed, which reflects the importance of estradiol in male brain function.

Part II: Transitioning to TRT “lite”

I very much liked some of the benefits of my recent TRT experiment, particularly the behavioral effects. However, I disliked the virilizing effects, which are also pro-aging effects.

Goals

• Elevate levels of testosterone and get many of the associated benefits (energy, dominance-behavior, muscle growth) without the virilization (e.g., increased hair growth, male pattern baldness) and rapid visual aging (e.g., changes in dermal elastin content, being much older looking than biological age) usually associated with TRT

• Elevate my levels of estradiol, which are always on the lower side – presumably because I carry little body fat, which expresses aromatase. Estradiol is particularly important for energy levels, mood, libido, and cognition.

• My reproductive axis not being shut down.

Protocol

After playing around with different variables for a little bit, I found a regimen that, for me, achieves all these goals.

The regimen is simple:

• 100 IU hCG per day. This dose is considerably lower than the average hCG dose. In my opinion, most people use far too much – particularly young people with healthy testes.

• 0.125mg finasteride per day

Because hCG stimulates intratesticular aromatization it is known to elevate levels of E2 disproportionately, which for me is a plus because my E2 levels are on the lower site. Fun fact, after about 10 weeks of pregnancy a female body produces about 500.000-200.000 IU of HCG per day, I am using about 0.5% of that. Most of the HCG available in the pharmacy is HCG derived from the urine of pregnant women.

While the addition of finasteride may reduce some of the testosterone-associated mental benefits, I find that, for me, it does not reduce them at all. I have now been on it for about 1 year and have zero side effects (as far as I can tell). Furthermore, the benefits that are due to an increased level of estradiol remain untouched. If I had to choose, I would happily trade in some of my DHT for increased E2.

Disclaimer: Finasteride is a potentially risky business. I know about half a dozen people on finasteride and, other than the beginning, nobody noticed any side effects. However, anecdotally, for some men, finasteride has a lot of downsides, including depression (and rare reports of suicidal ideation), brain fog, and libido issues. Furthermore, there is a risk of post-finasteride syndrome – though the risk is probably much smaller than what online communities make it out to be as most people who have no side effects on the drug just move on with their lives and do not write about it. In other words, the internet is a magnifying glass for the people who have a negative experience with a drug. Anyway, I used a specific strategy to lower the risk of PFS occurring – outlined in the article.

Blood levels after 4 months on this protocol:

• Testosterone: 910ng/dl (range: 350-826) (Note: On hCG my levels are less subject to the natural circadian variation essentially raising my AUC-levels of testosterone more than what the snapshot by a blood test would predict.)
• Bioavailable testosterone: 4.83 ng/ml (range: 1.260-4.110)
• SHBG: 36 (range: 16-60)
• Estradiol: 33pg/ml (27-52)
• LH: 1.2 mU/ml (range: 1.7-8.6)

Blood levels after 8 months on this protocol:

• Testosterone: 1090ng/dl (range: 350-826)
• Bioavailable testosterone: 4.83 ng/ml (range: 1.260-4.110)
• SHBG: 31 (range: 16-60)
• Estradiol: 42pg/ml (27-52)
• LH: 1.21 mU/ml (range: 1.7-8.6)

I was actually surprised that my free testosterone is above the reference range while I am not even shut down. The fact that my HPTA is not shut down (while my testicles are stimulated by the hCG) means that it would probably take me only a couple of days to recover my baseline HPTA function should I ever want to come off – and without harsh PCT drugs.

Scientific background

The anabolic-androgenic ratio is the ability of an androgen to provide anabolism (essentially muscle growth) vs. virilization (e.g., body hair growth, beard growth, oily skin, the growth of androgenic tissues such as penis and larynx during puberty, etc.). Different androgens have different anabolic-androgenic ratios. For example, oxandrolone (Anavar) has a phenomenal anabolic-androgenic ratio of roughly 1:7, meaning that molecule for molecule, oxandrolone is 7x more anabolic than it is androgenic. Hence it is frequently used by women as their preferred anabolic steroid.

By default, testosterone itself has an anabolic-androgenic ratio of 1:1 and DHT has roughly an anabolic-androgenic ratio of about 1:5. When it comes to testosterone itself (in the presence of an 5a-Reductase inhibitor which prevents its conversion to DHT), testosterone itself is quite balanced but DHT itself is mostly androgenic and weakly anabolic (as it is broken down in muscle tissue).

This can be seen well in individuals with mutations in 5aR-enzymes. They have normal testosterone levels and low DHT levels. They look mostly like men (incl. muscle growth, bone structure) but they are poorly virilized (e.g., micropenis, little body hair).

After adulthood is reached and virilization is mostly completed (e.g., voice changes, penis size, hair follicle maturation), in my opinion, DHT does more harm than good if testosterone levels are otherwise high. The high levels of testosterone are sufficient to compensate for a reduction in DHT levels (which would e.g., affect libido and many androgenic behaviors). DHT also leads to male pattern baldness, oily skin, prostate growth, lots of body hair growth, and a fast-aging phenotype. Some characteristics (such as sex drive, motivation, and cognition) are served by both T and DHT and either high T or normal DHT would be enough by themselves to activate these traits.

Therefore, after virilization is mostly completed, in my opinion, the ideal phenotype is having high levels of testosterone but low levels of DHT. The high levels of testosterone give many of the good aspects that are associated with T (e.g., libido, drive, muscle mass, bone, fat loss) but by preventing its conversion into DHT one does not get most of the bad stuff (e.g., hair growing in places you did not even know could grow hair, prostate growth, excessive libido). Sure, some gains in terms of libido and aggression and dominance behavior may be left on the table but, in my opinion, too much of these is a bad idea anyway.

Obviously, messing with DHT is more dangerous if total T levels are low. The reason for the evolution of the DHT-mechanism is to be a tissue-specific amplifier of androgen levels. If total T levels are low, DHT can still amplify androgen action locally (e.g., very important in the womb, childhood, and adolescence). Said in other words, if T levels are low, one “needs” the DHT to compensate for the low T in specific tissues so that still enough androgen signaling is present. Conversely, if T levels are high, one does not need the DHT because the testosterone itself can fulfill many of the DHT roles.

So, knowing all of this, one can calculate the anabolic vs androgenic properties of my protocol:

Testosterone has an anabolic-androgenic ratio of 1:1. DHT has an anabolic-androgenic ratio of about 1:5 and some people even say 1:10 (meaning that DHT is much more androgenic than testosterone). Furthermore, plasmatic levels of DHT do not tell the whole story because much of the local amplification of T into DHT (e.g., in the hair follicles and prostate) is not reflected by plasmatic levels. In these “androgenic” tissues, levels of DHT often exceed levels of testosterone, meaning that while in the plasma about 1 out of 10 testosterone molecules is DHT, locally, often DHT molecules outnumber testosterone molecules. In fact, some studies show that in the skin and scalp DHT levels outnumber testosterone levels by 10:1 (vs. 1:10 in the plasma). Consequently, finasteride has an outsized impact on androgenic tissues that is not picked up by a normal blood test.

So, how androgenic vs anabolic is my protocol?

My normal testosterone levels are roughly 600-700ng/dl in the morning. In the afternoon they are about 400ng/dl, leading to a daily average levels of about 550ng/dl. At this levels, my DHT levels would be roughly at 50-60ng/dl (about 10% of total). So, if my natural state is my default state (100% anabolic and 100% androgenic as a reference), then on my TRT lite protocol (total T at around 1000ng/dl with less fluctuations; DHT of around 100ng/dl but reduced by 70% due to the finasteride), my total androgenic load would come out as around 80-90% of my natural state (purely judged from plasma levels) and my total anabolic load would be 150-180% of my natural state. In other words, my total androgenic load is overall lower than my baseline whereas I benefit significantly from the benefits of increased testosterone levels.

However, this calculation was done using plasma levels. In reality, plasma DHT levels do not fully capture tissue-specific androgenic activity, which, as mentioned, is often deviates a lot from plasmatic levels. Accounting for tissue-specific DHT amplification the overall androgenic burden in DHT-sensitive tissues is likely reduced by much more than what plasma levels capture. If I had to guess, my androgenic state is roughly at 60-70% of my baseline state instead of the 80-90% calculated above.

Hence, in theory, my protocol shifts the balance in favor of the “good” sides of TRT (e.g., muscle growth, emotionality, libido) which are mediated by testosterone and estradiol. Conversely, the “bad” sides of TRT (e.g., hair loss, oily skin, body hair growth, fast-aging phenotype, excessive libido, excessive dominance behavior) are reduced.

One has to keep in mind that roughly 50% of the benefits of my TRT protocol are not due to testosterone but rather due to the higher levels of estradiol, which I did not even discuss in the paragraphs above.

Changes I noticed

It seems that many people partially hop on TRT mostly because they want to look better. However, a couple of years down the line, many people look much worse and older. While not as potent as the proper TRT I did before, I feel that this “TRT lite” gives me many of the benefits without the downside of virilization and quickly making me look much older.

• My baseline energy levels are definitely higher.

• My favorite change is that I now feel more deeply and I am moved to tears quite often. It is fascinating how emotional intensity can be changed by changing hormones.

• Unlike with the proper TRT I did before, I am not sure whether my dominance behavior has changed much, which may either be due to the honeymoon phase being over, it being so subtle that I do not notice, or because the addition of finasteride cancels out the effects of increased testosterone levels. For some time I used a microdose of rasagiline to counteract the finasteride-induced depletion of dopamine synthesis in the ventral tegmentum, a site rich in androgen receptor expression but I recently came off that.

• My body odor returned to “normal” – presumably due to the finasteride.

• My libido is much higher than before to the point of it sometimes being distracting. As far as I can tell, finasteride has not affected my libido.

• I gained about 6kg of weight, which I guess is equally split between water retention, muscle mass, and fat.

• As I started the finasteride, I had weak erections for 1 week (though my libido was unaffected). After the first and second dosage increases, I also noticed puffy nipples, which I managed effectively with a self-made topical cream containing the weakly androgenic DHT-derivative oxandrolone (explained here). A DHT-blood test (which oxandrolone would cross-react with as it is a DHT derivative) has shown that there is no systemic absorption. The puffy nipples would have probably gone away on their own eventually. Gynecomastia is a rare side effect of finasteride.

• Despite the finasteride (which I started at only 0.03mg per day for the first 3 months) I noticed a slight increase in body hair growth. Therefore, I doubled my finasteride dosage after 3 months to 0.06mg per day and I doubled my dose again 6 months after reaching a final dosage of 0.25mg. I barely had any side effects and the hair that had grown on TRT regressed (i.e., while body hair spiked after my TRT experiment, it decreased again after adding the finasteride. I have now about the same amount of body hair on HCG + finasteride as I did before my 2^nd run with TRT).

Overall, I have been on my TRT lite protocol now for a little over a year. I can safely say that increasing my levels of testosterone & estradiol has increased my quality of life and probably also my health, presumably mostly because it lifted me from a “low E2 state” into a “decent E2 state”. While it is not “life-changing” by any means, overall I feel it to be quite a strong net benefit to multiple aspects of my life.

Given that I am not shut down (neither my hypothalamus-pituitary nor my testicles) and given that I prevent most of the irreversible virilization and rapid visual aging by the addition of a low dose of finasteride, I can easily come off anytime without having regrets about having done irreversible damage to the way I look (my looks are tied to my self-esteem more than I would like and therefore I would hate myself for wrecking them).

I will try to keep this article updated. Sign up for my newsletter to get notified about changes in thinking and updates.

It is not just me!

I recently had a patient who “felt like shit” all the time. Among other things, his T was borderline low. I put him on 100 IU HcG per day, and despite being in his 40s, 3 months later, his T was around 900 and his E2 perfectly in the middle of the reference range. He now feels “like shit” much less, though T was not his only issue. Another friend of mine is on just 50IU HCG per day and feels very good on it.

My friends and I use 1500 IU vials of HCG we mix with bacteriostatic water. I usually put the vial beneath an egg cup in my fridge to protect it from light.

The upside of HCG is that at these dosages, most people will not be suppressed, which means that they can come off any time and should bounce back to baseline within a week or so (given that their HTPA is not fully shut down – i.e., LH/FSH unmeasurable). Furthermore, at these dosages, there is no Leydig cell hyperstimulation.

Another upside of HCG is that it stimulates adrenal steroidogenesis and “backfills” some of the other hormonal pathways.

Many people complain that HCG raises their E2 too much, but in my opinion, this is mostly because most people use too high of a dosage and too low of a frequency (e.g., 250IU twice per week). HCG does elevate E2 disproportionately, particularly due to intratesticular aromatization, but again, this is dosage-dependent. 100 IU once per day raises E2 less than 350 IU twice per week, despite being the same weekly dosage.

In my opinion, daily low-dose HCG should be first-line therapy for low testosterone, and only if there is an inadequate response should people move on to injectable testosterone. Just as with other treatments, obviously, there will be people for whom HCG does not work for a number of reasons. Nonetheless, in my opinion, it is the lowest-risk testosterone replacement option out there, and for some, probably also the best.

The major downside with HCG is that its effectiveness depends on your Leydig cell function and at normal dosages (75IU – 150IU daily) it barely raises T levels above 1000ng/dl.

Experience with other hormones

• The Lifechanging Power of Hormones
• Thyroid hormones
• Testosterone (TRT)
• Cortisol
• Leptin
• Semaglutide

Disclaimer

The content available on this website is based on the author’s individual research, opinions, and personal experiences. It is intended solely for informational and entertainment purposes and does not constitute medical advice. The author does not endorse the use of supplements, pharmaceutical drugs, or hormones without the direct oversight of a qualified physician. People should never disregard professional medical advice or delay in seeking it because of something they have read on the internet.