Dr. Paul Stallone discusses some important considerations.
by Dr. Paul Stallone
Men have been undergoing testosterone replacement therapy (TRT) for decades. Many have had great success, while others have struggled with the treatment. This depends on many factors which vary from lifestyle to the quality of testosterone. One reason the treatment may not have worked well could be the lack of another important hormone.
Human chorionic gonadotropin (hCG) is a naturally occurring hormone found in low levels in males and nonpregnant females. We might be more familiar with hCG in pregnant women, as this is the hormone that is detected via urine and blood testing. While men produce almost undetectable amounts of hCG, they do produce luteinizing hormone (LH), which mimics hCG. LH stimulates the production of testosterone in the Leydig cells of the testicles. Without this important hormone messenger, the testicles would not know to make more testosterone.
As LH is almost identical to hCG, incorporating hCG into TRT can have significant benefits to the patient. Because every patient is different, so will be their TRT. We might require less testosterone than another patient, and that other patient may benefit from adding hCG when we do not. This, among other reasons, is why comprehensive blood work is essential before initiating any hormone replacement therapy program.
If we have been on an unsuccessful replacement program and did not have extensive blood work, we probably did not have all the information needed. Some male patients, usually those under 40 years of age, might have success using just hCG to increase their levels of testosterone. This is again where blood work and an experienced physician is invaluable.
Another benefit of hCG includes returning the testicles to normal size after TRT. Testicular atrophy can occur with some men that receive testosterone from an outside source like a pellet, cream or injection. Our brain does not send the LH hormone to the testicles when our body has high enough levels of testosterone. Our brain will not signal for more testosterone until the levels drop below normal, which would then stimulate production. This becomes a problem because supplementation may pause the production of testosterone, which may cause testicles to shrink. The problem can happen at different times and the mass lost will vary for each man. Fortunately, hCG can rapidly reverse this.
Receiving TRT is more than restoring our libido, it can also help prevent loss of muscle mass and strength, increase bone density, increase red blood cell production, increase energy and support fat distribution. Low levels of testosterone can also affect men emotionally. Depression, sadness, low motivation, low self-confidence and trouble with memory can be signs that our levels of testosterone are decreasing. If we are experiencing any of the above symptoms or are currently on a TRT program that we’re not completely satisfied with, consult with a naturopathic physician skilled with hormone replacement therapy.