Treatment options for Hypogonadism

Sounds like you have a damn good doctor. Hope you get into see the endo pretty quick and don’t have to wait a long time for an appt. Keep us posted.

The guy I was referred to would get me in quick, BUT he doesn’t take insurance and charges $750 for a 1 hour consultation. That’s pretty steep for me, so I decided to look for an endocrinologist who participates in my health plan. There are plenty to sort through, but its pretty difficult to identify who experience with male hypogonadism issues, as distinct from folks who focus on diabetes, metabolic disorders, or fertility objectives. (Maybe that shouldn’t be essential, but I know I’d feel better about it - especially if my urologist might eventually look to the endocrinologist if and when it becomes time for TRT. Anyway after looking through dozens of listings, I found a couple who have pretty heavyweight credentials. One of them has done a lot of publishing, including articles that touch on hypogonadism. The context is admittedly different, but at least hypogonadism should not be unfamiliar territory. Tomorrow, I’ll see how long I’d have to wait to see one of my preferred guys If the waits not TOO long, it might be worth it.

That sounds great! If I were you, I would call the urologist and get a referral from him to one of the ends you found. If the office questions it, just explain that the doc they referred you to is not covered by your insurance. Or he even may have another rec for someone who is in your network.

The referral will grease the wheels for getting you in sooner than if you just call up on your own. At least that has been my experience.

For what it is worth guys, I have been about 3 weeks without hCG. Ran out, pharmacy could not get, etc etc. I’ve been really feeling the lack mood wise. Lost that feeling of centeredness. Starting up again today.

Sta-kool: Good to hear things are poised to get back on track. Hopefully it won’t take too long to feel right again. Is availability a frequent issue? Is that just for hCG, or does that also happen with test?

This morning, I made an appointment (before seeing your good advice). I have to wait until May 18. I’m impatient for sure, but considering how long this has been going on, another few weeks won’t kill me. I eventually settled on a guy in Baltimore (inconvenient) who does some research as well as practicing. His research focus tends to be on pituitary (which is likely the area implicated by high FSH), and I know he has looked at some issues relating to hypogonadism. That may be as much as I can hope for at this point. (Its easy to find endocrinologists, but not so easy to figure out who has experience in areas that seem most relevant to me. Reproductive specialists, might be OK, but they seem to have an IVF/fertility focus. It s pretty easy to find folks who specialize on diabetes or on metabolic/weight loss issues. After that, though, I found it pretty hard to get much information folks with experience in areas that matter to me. (Maybe they all do to some degree, but I can’t help but think there should be easier to zero in on specialists.)

May 18th? That’s not bad at all! The guy sounds really good.

Testosterone is no problem, they pretty much keep that on hand. If they are out, they can get it in a day.

On the hCG, there was a shortage of the generic brand I was using. Then we found another generic brand, so everything worked out.

I just need to keep on the ball and make sure I give the pharmacist plenty of notice that I am going to need another vial. A vial lasts me about 90 days. But per the pharmacy/insurance the vial is a 30 day supply. So basically I am gonna refill the prescription at the 60 day point. That’ll give them plenty of time to get it.

Nice that you have some leeway with insurance time frames. My wife has to manage chronic pain with some tightly controlled substances. She periodically has some anxious moments at renewal time. No fun.

Nice that you have some leeway with insurance time frames. My wife has to manage chronic pain with some tightly controlled substances. She periodically has some anxious moments at renewal time. No fun.

Oops. Can’t see how to delete errors.

Very interesting.

How long does it take you before you notice something is off?

On a side note, I think I want to try HCG monotherapy first if my doctor allows it and see if I can function on that alone. But I imagine that it may be a pain in the ass when traveling and such since the HCG has to be stored cool all the time. As far as I know, testosterone on the other hand can be stored in room temperature.

I’d say a week or so. Worsened and sort crashed at week 3.

If past experience is any indication, I should get some of the feelings of calmness and well being in a week.

Yes, testosterone at room temperature, stored in the dark.

Yes, hCG refrigerated. The couple times I have traveled I put the vial in a Baggie with small refreezable ice pack in my carry-on. Then straight to the hotel room’s mini-fridge. But yeah, it is kinda a pain in the ass.

You can purchase HCG in generic form from overseas pharmacies. Search for “corion 2000”. Works just as well and cheap also. There’s other brands but I have no info on those. Maybe purchase a few vials for when you’re in a pinch. The vials come dry and need to be reconstituted. If you do buy these, purchase some bacteriostatic water. The sterile water vials that come with the HCG are shit. There’s reconstitution guidelines that can be found on the internet. A bit of searching is needed. I would have provided links, but these were on my old computer and no longer can be accessed. Some of this may be found at Meso RX forums.

Just to note, HCG didn’t work for me because I’m primary.

I’m curious about this because it appears that I’m primary as well. After some additional testing its possible I may begin TRT. I can see how HCG would be ineffective at stimulating endogenous T production in testicles that aren’t responding to normal (or even elevated) levels of LH and FSH. However, I’ve read that some folks use HCG in conjunction with TRT with a goal of preventing or reducing testicular shrinkage. I’m not sure how/why this works in folks whose T levels are being elevated using TRT, but I’m wondering if HCG could be useful for that purpose even for guys with primary hypogonadism? (I’m actually not even sure shrinkage is an issue in cases of primary hypogonadism, but it seems like it could be. My body is still producing some T — although precious little free T—so it seems like that activity could shut down after TRT?)

I agree with sta-kool’s previous observation that shrinkage is a small price to pay for treatment that relieves major symptoms, so I’m not overly concerned about the shrinkage issue, although I read that some guys experience some real discomfort during the process. Also, since I’m not going to pretend I’m concerned about fertility, it seems possible that most doctors would offer me HCG in any case, but I’m curious how it works in conjunction with TRT.

In my case being primary, hcg had no effect on raising my T nor increasing my testicle size. My situation is a little diiferent than most. I had testicular cancer in 2002. I had a testicle removed. I was ok until 2005 at which time I noticed my remaining testicle starting to shrink, along with the usual low T symptoms. My LH & FSH numbers were very high. I started TRT at that time. My testicle remains small to this day.

Give the HCG a try. It may work for you. What’s the worst that could happen? I made a bit of a mistake in my previous post. I remembered that all HCG comes dry and needs to be reconstituted. Also, I do remember the chatter at the MesoRX website about waiting a day before shooting the HCG, after mixing it. There were those that claimed it was super concentrated just after mixing.

Good luck to you.

I applaud you gentlemen for being proactive about this. I’ve settled in to a nice weekly injection and I’ve never felt better. Mental clarity, sleep better and the positive side affect of the libido of a 25 year old. Only downside I can see is a bit of soreness at times at the injection site and I have to shave much more frequently.

As an aside, I’m not using any HCG protocol. My one good testicle is still the same size. My dead testicle has seen no change.