I have a big problem, please help me !!

THe hcg doseage is high. Can't comment too much on this as my knowledge is limited...but I think most try not to go higher than 750iu per day. Perhaps try 750iu eod for 4 weeks?

THe Clomid nolva is good. Personally I'd stretch that to 8 weeks nolva 20mg ED, and Clomid week 1-4 50mg and week 5-8 100mg, depending on the sides you get from Clomid.

I reckon that should work for you, although sure others have good info as well.

btw your test doesnt seem that low? Somewhat low, but sure I've seen worse?

all of your results are within the accepted ranges - I think ur problem is psychological and not physiological
however u could try for instance cialis and see if it works for u

the hcg is high but not harmfull, pct is like an opinion, everyone has a favorite regemine. I would do the hcg as the doc recommends, bump the Nolvadex to 40mg/day divided into twice daily doses, continue taking for an additional four weeks after you stop the hcg. I would do the Clomid at 100mg/day divided into twice daily doses( ie fifty mg two times/day). After you stop your shots of hcg, i would reduce the Clomid to 50 mg a day and continue taking it for an additional 4 weeks. If your libido still is not back, i would continue the nolvadex and Clomid for an additional four weeks. good luck.

jb

Posted by: jboldman

the hcg is high but not harmfull, pct is like an opinion, everyone has a favorite regemine. I would do the hcg as the doc recommends, bump the nolvadex to 40mg/day divided into twice daily doses, continue taking for an additional four weeks after you stop the hcg. I would do the Clomid at 100mg/day divided into twice daily doses( ie fifty mg two times/day). After you stop your shots of hcg, i would reduce the Clomid to 50 mg a day and continue taking it for an additional 4 weeks. If your libido still is not back, i would continue the nolvadex and Clomid for an additional four weeks. good luck.

jb

Jb, thanks for the exposition and the other that try to help me.
In fact, acording with my doctor I would continue with the Clomid and novaldex only 10 days after stopped the HGC and I have a friend that said that only 10 days after HCG wasn't enough and I wolud have to extend more 4 weeks as you said.
I will do it jb, I will increase the novaldex to 40 mg/day divided into twice daliy doses of 20 mg each and the Clomid with 100mg/day divided into twice daily dose.
When the HCG over, I will continue with 40mg/day of novaldex and reduce Clomid for 50mg/day for more 4 weeks.
If my libido doesn't get better I would take Clomid and novaldex for more 4 weeks.
Is it right jb??

I read one time a person that take HCG with shots of 2000 ui too , but he only take 4 shots of 2000 ui each 5 days with Clomid and novaldex and he got better.

God will help me and I will be better too.
Thanks a lot for everybody !!

Personally, I would run things much different than the way your doc outlined or the way that has been outlined here. Here is what I would do:

Weeks 1-3: hcg @ 500ius (every other day)
Weeks 4-6: hcg @ 300ius (every other day)
Weeks 1-18: nolvadex @ 20mgs every day
Weeks 7-18: Clomid @ 100mgs ED.

Below is a study that shows 500ius of hcg EOD resulting in intratesticular testosterone levels that were 125% of baseline value. Post cycle, the pituitary bounces back rather quickly, and with a surge of LH that is thought to be an attempt by the body to boost natural testosterone. I'm hoping this dose closely mimicks what our body would do naturally without desensitizing the leydig cells.

Second, if you plot out those values in excel and add a trendline to them, you'll find that 305ius EOD maintains baseline intratesticular testosterone. So after the "surge" (500ius hcg EOD), you're administering a replacement dose of LH for a few weeks.

Last, I believe it's smart to say on hcg a bit longer if since he has been "down" for so long.
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J Clin Endocrinol Metab. 2005 Feb 15; [Epub ahead of print] Related Articles, Links

LOW DOSE HUMAN CHORIONIC GONADOTROPIN MAINTAINS INTRATESTICULAR TESTOSTERONE IN NORMAL MEN WITH TESTOSTERONE INDUCED GONADOTROPIN SUPPRESSION.

Coviello AD, Matsumoto AM, Bremner WJ, Herbst KL, Amory JK, Anawalt BD, Sutton PR, Wright WW, Brown TR, Yan X, Zirkin BR, Jarow JP.

Center for Research in Reproduction and Contraception, Geriatric Research Education and Clinical Center, Veteran Affairs Puget Sound Health Care System (AMM), and Department of Medicine, University of Washington School of Medicine (ADC, WJB, JKA, BDA, PLS), Seattle, WA; Department of Medicine, Charles R. Drew University (KLH), Los Angeles, CA; Department of Urology, Johns Hopkins University School of Medicine (XY, JPJ), Baltimore, MD; Division of Reproductive Biology, Department of Biochemistry and Molecular Biology Johns Hopkins University School of Public Health (WWW, TRB, XY, BRZ, JPJ), Baltimore, MD.

In previous studies of testicular biopsy tissue from healthy men, intratesticular testosterone (ITT) has been shown to be much higher than serum testosterone (T), suggesting that high ITT is needed relative to serum T for normal spermatogenesis in men. However, the quantitative relationship between ITT and spermatogenesis is not known. To begin to address this issue experimentally we sought to determine the dose response relationship between human chorionic gonadotropin (hCG) and ITT to determine the minimum dose needed to maintain ITT in the normal range. Twenty-nine men with normal reproductive physiology were randomized to receive 200 mg T enanthate (TE) weekly in combination with either saline placebo or hCG 125 IU, 250 IU, or 500 IU every other day for 3 weeks. ITT was assessed in testicular fluid obtained by percutaneous fine needle aspiration at baseline and the end of treatment. Baseline serum T (14.1 nmol/L) was 1.2% of ITT (1174 nmol/L). LH and FSH were profoundly suppressed to 5% and 3% of baseline respectively, and ITT was suppressed by 94% (1234 nmol/L to 72 nmol/L) in the TE/placebo group. ITT increased linearly with increasing hCG dose (P < 0.001). Post-treatment ITT was 25% less than baseline in the 125 IU hCG group, 7% less than baseline in the 250 IU hCG group, and 26% greater than baseline in the 500 IU hCG group. These results demonstrate that relatively low dose hCG maintains ITT within the normal range in healthy men with gonadotropin suppression. Extensions of this study will allow determination of the ITT concentration threshold required to maintain spermatogenesis in man.

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Here is a study showing just how long Clomid supplementation needs to be post cycle to return nat. test. This is why I recommended the nolva/Clomid to be ran for 12 weeks after hcg cessation.

Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse.

Tan RS, Vasudevan D.

Department of Family and Community Medicine, University of Texas Health Sciences Center, Houston, Texas 77030, USA. [email protected]

OBJECTIVE: To report a case of symptomatic hypogonadism induced by the abuse of multiple steroid preparations that was subsequently reversed by clomiphene. DESIGN: Case report. SETTING: University-affiliated andrology practice within family practice clinic. PATIENT(S): A 30-year-old male. INTERVENTION(S): clomiphene citrate, 100-mg challenge for 5 days, followed by treatment at same dose for 2 months. MAIN OUTCOME MEASURE(S): Clinical symptoms, androgen decline in aging male questionnaire, total T, FSH, LH. RESULT(S): Reversal of symptoms, normalization of T levels with LH surge, restoration of pituitary-gonadal axis. CONCLUSION(S): clomiphene citrate is used typically in helping to restore fertility in females. This represents the first case report of the successful use of clomiphene to restore T levels and the pituitary-gonadal axis in a male patient. The axis was previously shut off with multiple anabolic steroid abuse.
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Here is some reading using a similar method to the one I outlined above.

i like R2E's regimen....i think 20mg per day of tamoxifen is high enough, where in my opinion 40mg is too much....even 20mg is max dosage daily for breast cancer patients.... also i see no reason to use clomiphene with the tamoxifen

I like the 500iu eod. Nolva 40mg perhaps for 3 weeks ok, thereafter 20mg should be fine. Clomid I would say is important for me in recovery, fro some it works very well, and I'd say it's worth a shot. If you wanna do this may as well do it properly.

both clomiphene and tamoxifen are SERMs can someone explain to me the rationale for using both?

Clomid stimulates directly the HPTA, tamox stimulates it indirectly by blockin the estrogen receptors in the pituitary/hypotalamus
though, I don't think that the simultaneous use is of any benefit .
Since its known that after some time the response to Clomid decreases I'd rather take 4 weeks Clomid and 4 weeks tamox (or sth like this)

the interesting thing is that almost everyones approach would probably work. here is a link to an abstract looking at this issue.

jb

Posted by: Zircon

I like the 500iu eod.nolva 40mg perhaps for 3 weeks ok, thereafter 20mg should be fine. clomid I would say is important for me in recovery, fro some it works very well, and I'd say it's worth a shot. If you wanna do this may as well do it properly.

But zircon, I am afraid to take a dosage like 500 ui that is a low dosage and it desn't work with me.
For this reason , i prefer to take a high dosage more for guarantee.
My doctor said that in this dosage will not have desensitizing the leydig cells that is 2000 ui every other day.
I read one time that a person take 2000ui of HCG each 5 days and works with him, in my case i will take 2000 ui each 2 days, i am a little afraid of doing it but i have to do it.
It is impossible for me to be worse than i am here.
After the treatment, whatever that happen with me is gain.
So , my treatment will be:
weeks 1 - 3 : 2000 ui hcg ( every other day) like my doctor said.
weeks 1 - 11 or 15 : 20 mg /day tamoxifen o
weeks 1 - 11 or 15 : 100 mg /day Clomid and after i reduce for 50 mg/day Clomid

I wish that it works.

And the last question:
During the treatment with hcg can i ejaculate normaly or i have to saty without ejaculation.

@Bomber Mor

Did you try to resolve your problem with exogenous testosterone, HRT doses(100-200mg weekly)?

yes you can ejaculate normally. I see no problem with those doses. The literature is full of hcg doses at that level for short periods of time with no negative outcomes.

jb