HCG/HMG
HCG is injected either intra-muscularly or subcutaneously. It can be used alone or in conjunction with Testosterone. Dosage varies, but it typically comes in a 5000iu vial of lyophilized power which needs to be mixed with bacteriostatic water. (NOTE: hCG typically comes with a sodium chloride solution, intended for a single injection; not bacteriostatic water) Mixing 2ml bacteriostatic water in a 5000iu vial of hCG will provide twenty 250iu doses. Each tenth of a cc/ml will be 250iu.
HMG is very similar to HCG, the key difference being that HCG acts as a synthetic LH (luteinizing hormone). hMG mimics both of the two key hormones produced by the testes to stimulate spermatogenesis: LH and FSH, making it more effective in maintaining fertility. However, hMG is often significantly more expensive than HCG.
As of March 23, 2021 the FDA has deemed hCG a biologic product and compounding pharmacies will no longer be allowed to provide this service
Testosterone vs. HCG
Testosterone is the most common, but has the potential to cause infertility and testicular atrophy during TRT use. HCG can be used in it's place or in conjunction at low doses to maintain fertility and testicular size. Whereas testosterone directly puts exogenous testosterone into your blood stream, HCG tells your body to create more endogenous testosterone.
Clomid
Clomiphene is sometimes used in place of testosterone/HCG. It is sometimes used in an attempt to restart HPTA, as well. Like HCG, it helps TRT-users maintain fertility. However, it can sometimes have unwanted side effects. It comes in an oral form and dosage can be 25-50mg ED, but may be tapered down based off BW.
Aromatase Inhibitors (AIs)
Testosterone can be converted in estrogen via the aromatase enzyme. Consequently, taking testosterone via TRT may increase estradiol levels. Most men on TRT dosages will not experience high estradiol levels. However, some genetically susceptible men may experience high levels. These high estradiol levels may lead to symptoms of high estrogen such as fluid retention and gynecomastia. As such, it is important to routinely test estradiol levels during TRT.
If estradiol levels are found to be too high, the most common treatment is Anastrozole (Arimidex) or Aromasin. Arimidex inhibits the aromatase enzyme, and thus it inhibits the conversion of testosterone to estrogen. Common medication and doses are 0.25-0.5mg Arimidex E3-7D or 12.5-25mg Aromasin E3-7D (depending on estrogen levels and response).
Normal estrogen range is about 7-42 pg/mL. Most users on this sub report that they feel best when they're at 20-30. However, many on this sub also feel that an AI isn't needed until/unless you notice symptoms of high estrogen.
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