Welcome to Part 4 of our comprehensive hormone replacement therapy (HRT) series (click for index).
In the past 2 sections, I shared the 2 primary hormone replacement therapy protocols that I have used for the past decade.
In terms of testosterone replacement, the results were -
#1 Underground Testosterone 250mg (every 7 days) + HCG 250ius (every 3 days) = 975-1200ng/dl (VERY HIGH)
#2 Underground Testosterone 250mg (every 10 days) + HCG 250ius (every 3 days) = 700-950ng/dl (HIGH-NORMAL)
Let's discuss the testosterone replacement therapy (TRT) element of these protocols, why I have come to prefer a high-moderate testosterone level over a high testosterone level and what I've learned along the way.
My Thoughts on Testosterone Replacement Therapy
(Testosterone = God Mode?)
Don't get it twisted.
Testosterone is great.
In many ways, it is the single hormone that defines us physically and psychologically as a man.
But after 10 years of manipulating my testosterone (and transition from no-life bodybuilder to "player/party boy" to always-overwhelmed owner of 5 different businesses), I can tell you with complete certainty -
For the average (non-serious bodybuilder) male, who does not have significant amounts of chemical muscle beyond his genetic potential to maintain -
More testosterone is NOT always better.
Even for competitive athletes who value their tendons and guys that simply want to maximize their sex drive -
More testosterone is NOT always better.
I have found, unless I am really physically active (gym 5+ days/week), that 700ng/dl (+/- 100) is the ideal testosterone level for HRT.
But not high.
I prefer 'High-Normal Testosterone' protocol #2 (250mg every 10 days, including HCG E3D = 700-900ng/dl), because it better controls or prevents oily skin, minor acne, ugly bloat, low HDL cholesterol, hair loss, estrogen, joint pain, appetite, body temperature and is slightly less expensive and hassle than shooting every 7 days.
You know, all those high-testosterone side effects that many guys simply come to accept.
'High Testosterone' protocol #1 (250mg every 7 days, including HCG E3D = 975-1200ng/dl), however, is better for maintaining lean mass gains and keeping off excess body fat (provided that your estrogen levels are not out of range). If you have a sizable amount of super-physiological (chemical muscle beyond your genetic potential) muscle to maintain, you will probably want your testosterone levels over 1000ng/dl and/or use at least 4ius of human growth hormone.
Surprisingly, I don't feel keeping my testosterone over 1000ng/dl for HRT offered any other advantages - only minor side effects, including obvious and annoying cosmetic inconveniences.
I feel and look no better with my testosterone at 1000ng/dl than at 700ng/dl.
In fact - I feel exactly the same and I look worse.
I have no greater energy level or sex drive when my testosterone is above 1000ng/dl, as compared to 700ng/dl.
Likewise, although my testosterone fluctuates (+/- 200ng/dl) in both protocols, this variation has never had an impact on how I feel.
(some people might benefit from more stable testosterone levels via propionate or sustanon/omnadren - but it never mattered to me)
I'm not alone on this "More Testosterone is Not Always Better" theory.
My good friend Victor Pride almost seems entirely "anti-testosterone" on purely aesthetic grounds -
More testosterone is an absolute physique ruiner. IMO more has never, ever been better for me.
I actually hate testosterone for the most part and use as little as I can. But more is absolutely awful for the physique.
What newbies and inexperienced guys often don't fully understand is when you inject testosterone (or take nearly my hormones that raises your total testosterone levels), that testosterone encourages or converts in substantial amounts to DHEA, DHT, estrogen and progesterone (not all bad, will discuss later).
There's a 'testosterone ceiling' where using any more simply results in diminishing returns.
That ceiling, in my experience, is only about 700ng/dl for HRT purposes.
(this will vary from person-to-person obviously)
That 'testosterone ceiling' is far lower than the 4-digit 1500+ng/dl "Alpha Bro" level that some guys think will make them jump over buildings and attract women with pheromones.
This might seem like common sense, but I can't remember the last time I saw a blog post or forum post that didn't either directly recommend or quietly suggest for every red-blooded male, regardless of age, jack his testosterone up as much as humanly (or super-humanly) possible.
For a half-decade I thought "more testosterone was better" and took pride in knowing that my testosterone level was 3-4x higher than the average guy - even though I looked like a bloated moron and getting all the side effects.
Again, this is only my opinion and my experience.
The ideal testosterone level depends on your lifestyle.
Our friend, Nate from Iron & Tweed, maintains a 1000+ ng/dl testosterone level which he feels is ideal for him.
When I was as physically active as he is, 1000+ ng/dl was the way to go.
Should I Consider Testosterone Replacement Therapy?
If you are in your 20's or 30's and your natural testosterone levels are at or over 700ng/dl (+/- 100) in the morning, you DO NOT need testosterone replacement therapy.
Don't get on testosterone replacement therapy just because "you are going to eventually do it", like I did.
Don't get on testosterone replacement therapy because you think that you will look twice as good and perform two times better at life if your testosterone is 1400ng/dl instead of 700ng/dl.
It doesn't work that way. Unfortunately.
Unless you legitimately have low testosterone levels, you won't even notice the difference.
Listen to me on this.
For the average semi-physically active guy, super high HRT testosterone levels will not offer any advantages unless he has significant amounts of steroid-built mass to maintain. HRT will be an expensive hassle that offers very few advantages and only weekly inconveniences if you don't need it.
However, if you are in your 20's or 30's and your natural testosterone levels are under 500ng/dl, especially if it is under 400ng/dl, you should look into hormone replacement therapy after trying to get it up naturally.
If you are in-between 500-600ng/dl, try these strategies and see if you can't bring it up to 700+ ng/dl.
If you aren't sure what your testosterone level is, just get it tested here (no fasting required) and you'll know in 48 hours.
I'm a huge supporter of "steroid education", male optimization and performance enhancing compounds. Legal or illegal, I'll do them once I learn how to use them responsibly.
The Internet is an incredible resource to learn how things work from other people with experience and not government written textbooks, a resource that we didn't have in the late '90's. Still, many 'Red Pill' guys start to convince themselves that they have problems and issues - that they simply DO NOT have.
Testosterone replacement therapy is no different.
You need to get bloodwork before you reach any conclusions about your endocrine system and the root cause of any physical or emotional issues.
The vast majority of guys reading this DO NOT have low testosterone levels and will not benefit from taking supplemental testosterone.
Do I Need to Get My Testosterone From a Pharmacy?
(Pharmacy Testosterone vs. Underground Lab Testosterone)
Legally speaking, I have to tell you 'yes'.
You should get it from a pharmacy via a prescription from your doctor.
As you can imagine, I've used both pharmacy-grade and underground lab (UGL) testosterone. I've even cooked my own testosterone from raw Chinese powder.
The real stuff is better, but more expensive.
I would estimate that, on average, pharmacy-grade is about 25-33% stronger that most not-totally-underdosed UGL products.
I remember reading in "Legal Muscle" by Richard Collins ESQ. that nobody with a real prescription has ever done time if they got 'caught' with a personal supply of UGL testosterone (or anything else, surprisingly). The book is from 2002 though.
Most bodybuilders get the prescription just to cover themselves and then take dosing and import matters into their own hands.
My Thoughts and Experience with Human Chorionic Gonadotropin (HCG)
(Rx injectable HCG, not oral "HCG drops")
I absolutely love HCG.
(it forces your body to produce natural testosterone instantly and makes your balls/loads pretty big, it is popular in the adult scene)
Somehow, the testosterone my body 'naturally' produces from HCG feels different than any synthetic injectable testosterone I've taken. HCG sends my libido through the roof, far more than any testosterone ester.
It sounds weird and maybe it's a psychological thing, but I know some guys that also agree.
While HCG is NOT mandatory for testosterone replacement therapy (most guys and doctors don't use it), I would never use any synthetic anabolic compound without it.
Basically, HCG "keeps your balls going" and prevents testicular shutdown that HRT or steroidals at any dose would otherwise cause.
So unlike most guys on hormone replacement therapy, my balls have not gone to sleep and actually produce as much, if not more, sperm as they would naturally. That is one reason that I have always been obsessive about using protection.
(while not always true - small testicles are the most obvious sign of low testosterone and sperm count, it's not just cosmetic)
Theoretically, since I have not had any testicular shutdown, I should be able to come off 10+ years of HRT and restore my natural production much easier. I have no intention of doing this however.
While HCG will cause your testosterone to spike (mine will increase +200-250ng/dl for a 24 hour period per 250iu sub-q injection, libido goes up considerably too), HRT HCG is arguably mainly for "cosmetic" purposes and sperm count.
I never ever got used to that "tiny balls" sensation that comes from using steroids. HCG completely negates this and you will even notice that your flaccid penis hangs considerably lower and package is bigger and more sensitive.
This is GLL-Lifestyle, the non-adult site, so we'll stop there.
When I travel for short periods of time, however, I rarely take HCG with me and within 5 days my balls are already ~50% smaller.
(pro tip: pack your mixed HCG in your luggage, an ice pack will help but it's not necessary. The air is freezing when the plane is in flight so your HCG will be plenty cold and it will be fine unless it gets really warm or stays out of the fridge for over 48 hours. You can also pre-load HCG into insulin pins and put a note on it that says 'diabetic on board - do not remove')
When I travel for extended periods of time, I'll take unmixed HCG with me. If you don't have a script, traveling with HCG is 'better' than traveling with testosterone because it's not a controlled substance. I have never had any trouble traveling with either and no longer mail it to my destination ahead of time.
What is HCG?
How Can It Help Men on Testosterone Replacement Therapy?
(Video about HCG for Men, Not About the "HCG Diet" for Morons)
My Non-Medical Opinion on Using HCG for HRT
(and as a Standalone)
It's 2015, but HCG is still misunderstood.
A lot of outdated generalizations remain from the 90's when many bodybuilders used aggressive HCG protocols (5000, 3000, 1000ius, 1-2x/week) as part of their post-cycle therapy. In hindsight, these large doses seem reckless and are not reflective of responsible HCG use (250ius, 2-3x/week).
It hasn't helped that the extremely unhealthful concentration camp "HCG Diet" has further clouded the reputation of this extremely useful compound.
One common myth about HCG is how it will eventually desensitize Leydig cells thereby inhibiting your natural testosterone production and sperm production if you take it for a prolonged period of time.
Some say - users will develop a 'tolerance' to HCG and will require larger-and-larger doses of HCG.
While this might be true of guys that take extremely large doses (old school dose - 3000-5000 ius, multiple days a week), I have taken 250ius of HCG, every 3 days, for 10 years and it works exactly the same as it did 10 years ago.
In my non-medical opinion, based on my experience, my friends and independent research -
HCG is completely safe to run indefinitely so long as you don't exceed 250ius per injection in a 24-hour period.
No one can convince me otherwise.
I have administered over 1500 250iu HCG shots and the stuff works better than ever.
My "HCG every 3 days" protocol was based on Dr. John Crisler's original HRT protocol which originally called for men to administer 2 250iu HCG injections in addition to their weekly replacement testosterone injection (via www.AllThingsMale.com) -
In my previous report I recommended 250IU of HCG twice per week for all TRT patients, taken the day of, along with the day before, the weekly test cyp injection.
After looking at countless lab printouts, listening to subjective reports from patients, and learning more about HCG, I am now shifting that regimen forward one day.
In other words, my test cyp TRT patients now take their HCG at 250IU two days before, as well as the day immediately previous to, their IM [Testosterone] shot. All administer their HCG subcutaneously, and dosage may be adjusted as necessary (I have yet to see more than 350IU per dose required).
Dr. Crisler argued for years that HCG was a safe, very beneficial addition to any male HRT protocol but large doses (anything over 500ius) absolutely needed to be avoided -
It is important that no more than 500IU of HCG be administered on any given day. There is only just so much stimulation possible, and exceeding that not only is wasteful, doing so has important negative consequences. Higher doses overly stimulate testicular aromatase, which inappropriately raises estrogen levels, and brings on the detrimental effects of same. It also causes Leydig cell desensitization to LH, and we are therefore inducing primary hypogonadism while perhaps treating secondary hypogonadism.
250IU [of HCG] QD is an effective, and safe, dose.
(note: this is only Dr. Crisler's and my opinion - apparently Rich Piana still takes large amounts of HCG)
John Crisler was the online pioneer of HCG for HRT.
Back in the day, he was the 'Patrick Arnold' of the field and the only doctor I can remember that was willing to be quoted and published on the subject.
That may not seem like a huge deal now, but in the early 2000's, Congress and the media were doing all they could to smear and imprison credible physicians and baseball players for this kind of thing.
Dr. Crisler often discussed how he would rather see his patients use 250ius of HCG everyday (if necessary, 1750ius/week) rather than using even 1 single dose that exceeded 1000ius.
I have taken HCG without testosterone for a couple of months and felt completely normal. The stuff has always worked great for me and my sex life.
Still, like Dr. Crisler, I feel that the combination of injectable testosterone and small doses of HCG (250ius or less) is the very best HRT protocol -
While HCG, as sole TRT, is still considered treatment of choice for hypogonadotrophic hypogonadism by many, my experience is that it just does not bring the same subjective benefits as pure testosterone delivery systems do—even when similar serum androgen levels are produced from comparable baseline values.
However, supplementing the more “traditional” TRT of transdermal, or injected, testosterone with HCG stabilizes serum levels, prevents testicular atrophy, helps rebalance expression of other hormones, and brings reports of greatly increased sense of well-being and libido.
My patients absolutely love it.
As time goes on, we are coming to appreciate HCG as a much more powerful--and wonderful--hormone than previously given credit.
I concur 100%.
In fact, HCG gives my sex drive a kick far beyond any libido boost that is second to none.
These days, I simply take HCG whenever I feel I need it. But never more than 3 days a week and certainly not more than 250iu per subcutaneous injection. While this isn't particularly disciplined, I really know my body and this has worked perfectly for me. My doctors and bloodwork agree.
"Testosterone Replacement Therapy - How to Administer Expert TRT"
by: Dr. John Crisler
References for Dr. Crisler statements
Should I Consider Taking HCG To Increase My Testosterone Levels?
If you are taking testosterone - yes, you can speak to your doctor about incorporating it into your HRT protocol.
Although HCG should certainly increase your testosterone levels as a standalone, like testosterone, you should have a doctor prescribing it for you. It is not something you temporarily "cycle" or use like a steroid.
Further good reading about HCG -
Nate from Iron & Tweed tried HCG-mono (standalone) therapy for about 4 months and his testosterone levels jumped about 150 points.
It wasn't enough for him since Nate actually had low testosterone to begin with (and was not just trying to 'optimize' his hormone levels). When he added synthetic testosterone to the mix, his testosterone levels skyrocketed.
Taking our 2 experiences into account, this suggests that HCG-mono therapy may only benefit guys that can efficiently make their natural testosterone high and may not be enough if your testosterone is below 300ng/dl.
Just my thoughts.
We are just 2 case studies, so don't arrive at any conclusions.
Here is a third voice, Jay Campbell, he has 15 years of experience with testosterone replacement therapy -
Where Can I Get HCG?
Talk to your doctor.
Are There Any Testosterone Boosting Supplements That Work?
The answer is -
I don't really know.
Since I've done HRT for the past 10 years, I'm out of the loop when it comes to 'natural testosterone boosters'.
Since I do HRT, I'm not a candidate to test any products, nor would I like to be.
Call me ignorant on this topic, but what I do know is - the vast majority of dietary supplements will do ABSOLUTELY NOTHING because you need to have nutritional deficiencies to actually benefit. Unless you are following the vegan diet or live in a developing nation - it is very unlikely that you have any major nutritional deficiencies.
It is also unlikely that your testosterone is low.
Unless you are recovering from a steroid cycle (in which case a supplement might help your testosterone levels come back naturally), it is unlikely that there are any legal (natural) non-hormonal testosterone supplements that is going to make a significant difference.
Most supplements make a "1% difference", as I always say.
If you know of an over-the-counter "testosterone booster" that is legitimate - let us know in the forum. Show your bloodwork too - it's the only thing that matters.
Interesting GLL fact: I receive 15+ offers a month to "review" (aka promote) different products for you guys. 20% of the offers are 'testosterone boosters'.
I'm Interested in Meeting a Testosterone Replacement Therapy Doctor. But I Don't Know Where To Begin, Any Help?
You probably don't have an endocrinologist (I was the only weirdo that had one when I was in my mid 20's) and it can be a costly hassle to get a referral to a good one. Especially if you don't know the "lingo".
You are in luck, skip the middleman and go right to the doctor himself -
note: I receive absolutely no money or prizes if you use the service that Jay recommends, I'm not a patient of Dr. Crisler's either.
It just turns out that Jay knows Dr. Crisler personally and I was writing about him.
Final Thoughts on Testosterone Replacement Therapy
Many probably assumed that this series on hormone replacement therapy would be a non-stop endorsement of how I have been living in an alternate 'superman' universe because my testosterone levels are double or triple the average male and it is my hidden secret to my success with women and in business.
Although I have no regrets about my rather impulsive decision to self-administer my own hormone replacement therapy starting 10 years ago, I urge you guys to NOT start hormone replacement therapy unless you actually need it.
That means -
Unless your testosterone is below 500ng/dl and you have been unsuccessful in trying to bring it up naturally - you don't need it.
Literally, you don't need it and it WILL NOT benefit you.
In my experience, I feel absolutely no different when my testosterone is 1000-1300ng/dl than when it is 600-800ng/dl.
Other than maintaining muscle mass, the benefits (if any) of a prolonged super-high testosterone via HRT were purely psychological.
The side effects, while largely aesthetic and minor inconveniences, were noticeable.
'Male optimization' (producing optimal hormone levels) is not a "scam", but it will only benefit guys who actually NEED IT.
This is something I wish I heard when I was 23.
In my experience -
You WILL NOT feel a difference if your testosterone is 700ng/dl or 1000ng/dl.
However, if your testosterone is <300ng/dl - it will make a HUGE difference.
Very few guys in their 20's or 30's will have a level that is this low though.
I don't expect everyone around this side of the Internet to agree with me. To some, I am very much "bad-mouthing" testosterone replacement therapy and deserve to have my HCG taken away so my balls shrink.
But remember, I've been at this for over a decade, far longer than many that sing non-stop praise for steroids, male optimization and super high testosterone levels.
With that said, testosterone replacement therapy can be a game-changer if your testosterone is low.
But if it's not low, you have just added an expensive, completely unnecessary inconvenience to your life.
Our series on hormone replacement therapy continues here -
Super helpful testosterone replacement therapy resource -
Non-medical questions and comments on in-depth subjects such as hormone replacement therapy are best left in our forum, blog comments have been disabled.