Hcg minics LH, its derived from urine of pregnant women. Since it acts as LH, it stimulates the testes into producing testosterone. This stimulation also maintians testicular size.
That said, since it merely mimics LH , natural LH is now suppressed because hcg is doing its job for it. Clomid will help minimize this but it depends on the dose and duration of hcg. As for DHT, its 5 times more androgenic than testosterone and is responsible for most unwanted side effects such as Hair loss, prostate enlargement, and acne. Dht is somewhat of a natural anti estrogen though. Still, you dont want high levels of dht for sustained periods of time.
The range for DHT is 35-75 i believe. also, sustained levels of Testosterone over 1000 may feel good but it can eventually have a negative affect of the cardiovascular system. Thats almost a steroid cycle and you run the risk of raising LDL, lowering HDL, and enlarging the heart.
A level of 1200 is very unnatural. This can prematurely lead to prostate enlargement which most men get after 50 anyway. BPH ( prostate enlargement) is basically a quality of life issue. You may already notice waking up at night to urinate and perhaps your urine stream is weaker than it used to be. It can take you longer to fully empty your bladder. Those are signs of bph.
Excellent advice from a scientific point of view, in my opinion, so long as "may" replaces "can". Ideally, for males under 70 and for good overall health I'd shoot for total T in the 600 to 900 range and that would allow for the occasional excursion above or below. (regardless there will be no benefit above the saturation point, and possible harm. I don't know if anyone knows where the saturation point is, but it's probably somewhere between 1000 and 1500 for most men --- it will be higher for the geriatric because of high SHBG levels.) Above age seventy a somewhat different situation pertains, probably for evolutionary reasons. Above age 70 our SHBG levels will begin to rise which will inactivate T, so it becomes necessary to do a T panel occasionally which will allow computation of free T which is what matters.* You can have total T above 1000 after age 70 and be OK. You may need total T > 1000 particularly after age 80 because SHBG goes up non-linearly with age.
One of the most important papers published to date on hormone replacement for men is a study from 2008 available free at the NIH site PubMed. Make a copy and give it to your Urologist or Endocrinologist. It may be nearly impossible to get them to read it, however, because it seems few practicing M.D.s rarely, if ever, read the Journal literature and will often be dismissive of any information provided by their patients. (One of many reasons American medicine, by a wide margin, is the worst in the world among developed countries.) This is a dynamite 2008 paper: "The Effects of Growth Hormone and/or Testosterone on Whole Body Protein Kinetics and Skeletal Muscle Gene Expression in Healthy Elderly Men: A Randomized Controlled Trial". Its a joint study from Kings College (UK), St. Thomas Hospital (UK), and the Mayo Clinic (USA). J. Clin Endocrinol Metab. 2008 Aug;93(8): 3066-3074. the PubMed citation: PMCID: PMC2515076 and PMID: 18477661
This study show that T and GH supplementation is synergistic, i.e., each is more effective in the presence of the other in men 65-75. Older men have lowered protein turnover rates. I would guess younger men might not experience much benefit from supplementing TRT with GH. Very likely the benefit of GH supplementation would track the age relationship of TRT benefits.
Also of great interest to those on TRT is: Testosterone treatment and the risk of aggressive prostate cancer in men with low testosterone levels. This is an open access paper from 2018.
https://doi.org/10.1371/journal.pone.0199194 Conclusion: "No association between cumulative testosterone dose or formulation and CaP [prostate cancer] was observed."
This is consistent with new studies which are all suggesting that maintaining T levels in a healthy range with supplementation for older men, rather than increasing the risk of prostate cancer, as is still commonly believed by many physicians, many actually lower the risk of prostate cancer. Some physicians will tell you that although T does not cause prostate cancer it can accelerate its growth. This is very likely also wrong. The latest studies suggest that correlation between T levels and both the incidence of prostate cancer and its aggressiveness is either zero or negative rather than positive. The medical community believed it was positive for many years, and that's still believed by many urologists.
The incorrect thinking with regard to prostate cancer and testosterone stems from a 1940s paper by Holmes and Huggins. Huggins later won the Nobel prize in medicine. This Holmes/Huggins paper, in my personal opinion, has done tremendous damage to men's health because it led to the standard treatment for prostate cancer having included the chemical knocking-out of the natural production of T by the testes, making the patient weaker, and, of course, miserable. This chemical castration is still going on, even though it is looking more and more as though it is not only unnecessary but actually harmful to the patients health. A widely acknowledged T guru is Abraham Morgentaler from Harvard. I think he would agree with me. (Do a YouTube search for him; and also search for A. Morgentaler at PubMed. )
Here is some advice I am happy to pass on. Don't let any ordinary physician run a PSA test on you if you are in your eighties or above. Hardly any of them know what's the normal range for those above age eighty, it's at least up to 6.5. Physicians rely on the lab printouts of supposedly normal levels and these vary depending on who made the lab equipment used, etc., and none are even close to correct for eighty year-olds when it come to PSA. Always insist on a digital exam, an ultrasound or an MRI of the prostate. Never a PSA! A cheap digital exam is fine so long as there are no signs of trouble. This is also good advice for younger men too. Insist your urologist give you a digital exam. ( If they don't like sticking their finger up your ass, why did they go into urology?)
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*Some are saying indirect determination of free T via calculation from Total T, Albumin, and SHBG is more reliable than direct laboratory measurement of free T. I don't know for sure why, but I would guess it's because because free T is plasma occurs at very low levels so its direct determination, besides being expensive, is subject to large relative error, whereas Total T , Albumin and SHBG all occur at orders higher in concentration and so are subject to much lower relative error. For this reason I wouldn't bother to pay for direct measurement of free T, but instead insist on the free T being determined by calculation. (It is free T that we respond to, not total T, according to Morgentaler.)
