Prescribed HCG

HCG and Testosterone


If you’re on testosterone therapy you don’t need HCG right? IMT and our clients would disagree. HCG is a staple in our protocol and helps to avoid the suppression or reduction in the HPTA process, and the hormones that are produced by that process. If I were to tell you let’s take the alternator out of your car and we will just keep the engine on the whole time don’t worry about it, would that worry you? It should because it’s not likely that will be good for your car long term.


First we need to go over a quick rundown of how the HPTA (hypothalamic-pituitary-testicular-axis) works. Your pituitary is controlled by a response mechanism called the “negative feedback loop”. This simply means hormones talk to each other and tell this axis to speed up or slow down depending on the current levels in the blood stream. If a certain hormone level is high, it will signal to slow down the production of this hormone or terminate it completely. So when you inject or apply testosterone from outside the body, this negative feedback loop shuts off your natural testosterone. This is why it is called testosterone replacement because it completely replaces your testosterone. This is why it’s important that only men that have a testosterone deficiency take testosterone.


The HPTA works by signaling the pituitary to send out LH and FSH to the testicles. LH goes to the Leydig cells in the testicles and tells them to produce testosterone. FSH goes to the Sertoli cells and tells them to produce sperm. So when you take testosterone from outside the body these 2 signals slow down or shut off completely. HCG can offset this suppression by mimicking the LH signal, making the testicles think they should continue to make testosterone, and subsequently the other core sex hormones that testosterone gets converted into like estradiol, DHT and progesterone.



When you take exogenous testosterone this can decrease fertility. When shutting down the testicles your are not only shutting down testosterone production but also spermatogenesis. Taking HCG with your testosterone will keep the testicles working and increases your chances of maintaining fertility a ton. Many of our clients conceive while on one of our programs. In the following study, HCG maintained sperm levels in all participants:

Conclusion: Low-dose human chorionic gonadotropin appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy.

Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy.


Yup I said it, your testicles are going to shrink if you take testosterone without HCG. The testicles become inactive or desensitized because they are not receiving LH or FSH and this causes the cells to shrink. Taking HCG with your testosterone will mitigate this and keep them partially functioning and keep their size the whole time.


After long periods of testosterone administration many men report a reduced ejaculate volume. This can make things less sensitive and take the pleasure out of the entire process. HCG will sensitize the leydig cells and improve your volume and sensitivity in that region when you do ejaculate.


HCG has other duties besides telling the testicles to make testosterone; it even stimulates the pituitary in this complex loop. One enzyme in particular is the p-450 side chain enzyme. This enzyme is responsible for converting your cholesterol into pregnenolone and then into other core hormones like DHEA, TSH and Cortisol. If this stimulation does not happen it can make these important hormones deficient and cause other problems besides your T levels.


Some men optimize T levels and their sex drive stays unchanged. This could be due to the lack of progesterone production or adrenal insufficiency. HCG could fix this problem and has in many men. Reports of men on TRT touting “HCG is the best hormone for men since testosterone” are all over the Internet. This is due to HCG’s ability to stimulate other hormones besides testosterone such as progesterone, DHT, Estradiol and adrenal hormones.


Contained in vials of 3,500 IUs, 5, 000 IUs or 10, 000 IUs (depending on the compounding pharmacy these amounts may vary). These are usually accompanied by another vial of bacteriostatic water to reconstitute the powder into a liquid solution. Bacteriostatic water (water with a preservative that is provided with the prescription) is mixed in with the powder to reconstitute, or dissolve, it before injection. This type of water can preserve the solution for up to 10 weeks when refrigerated. Some patients do not use the 1 mL water vials that come with the commercially (non compounded) available product and instead get their doctors to prescribe 30 cc bottles of bacteriostatic water so that they can dilute the HCG down to a more workable concentration that is more practical for men using lower doses of HCG weekly.

HCG is injected under the skin or intramuscularly (there is still debate on which method is best). The number of IUs per injection will depend on how much bacteriostatic water you add to the dry powder vial. If you add 1 mL to a 5,000 IU powder vial, then you will have 5,000 IUs per mL, so 0.1 mL would be 500 IUs. If you add 2 mL to the 5,000 IU dry powder vial, then you will have 2,500 IUs/mL; 0.1 ml (or cc) in an insulin syringe will equal 250 IUs. If you need to inject 500 IUs, then you inject 0.2 ccs of this mixture.

Ultra-fine needle insulin syringes are used to inject HCG under the skin
 making this very easy to take even for the needle-phobic
Compounded HCG is a lot cheaper than the commercially available pharmaceutical products. Also, it is sometimes difficult to find commercially available HCG in regular pharmacies.


Using HCG as sole testosterone replacement option does not bring the same subjective benefit on sexual function as pure testosterone delivery systems do, even when similar serum androgen levels are produced from comparable baseline values. However, supplementing the more “old-fashioned” transdermal, or injected options, testosterone with the correct doses of HCG stabilizes blood levels, prevents testicular atrophy, helps rebalance expression of other hormones, and brings reports of greatly increased sense of well-being and libido. But in excess, HCG can cause acne, water retention, moodiness, and gynecomastia (breast enlargement in men).

Don’t let the fate of your HPTA stand in the hands of someone who does not understand suppression and its consequences, call IMT today and get on a program that address all the concerns of men on TRT.

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