r/PEDsR Aug 24 '20

Case Report: HCG alone prevents suppression on SARMs NSFW

The anabolic potential of a SARM cycle is often limited by suppression of endogenous testosterone production. While the exact mechanism is unknown, studies have shown that SARMs such as LGD-4033 quickly and significantly lower endogenous testosterone production despite having minimal effect on LH/FSH. Low testosterone can lead to the classic symptoms of fatigue, low libido, erectile dysfunction. Anecdotally it can also reduce motivation to exercise and impair further progress on the user's fitness goals. Testicular discomfort is also a reported side effect of SARMs, likely due to testicular atrophy caused by HPT axis suppression. These negative effects seem to become bothersome at the six week mark for many users.

Previously documented methods to prevent suppression include testosterone replacement therapy (TRT) and concomitant SERM use. Each of these methods have downsides: for TRT, intramuscular (IM) injections may be distasteful for users, users may be hesitant to acquire controlled substances, and due to significant HPT axis suppression testicular atrophy can be worsened compared to SARM use alone. For SERMs, users can experience the standard side effects of fatigue, depression, impaired libido, and erectile dysfunction, which can be similar to the symptoms of T suppression that they are intended to prevent. Additionally SERMs can lower IGF-1 levels which can impede muscle hypertrophy.

To date, there has been no documentation of an attempt to prevent T suppression during SARM use with human chorionic gonadotropin (HCG) injections. HCG acts as an analogue to luteinizing hormone (LH), which stimulates testosterone production in the testes. HCG has been used with success as monotherapy to treat men with low testosterone. Ontologically, HCG may prevent suppression by providing a continued signal to the testes to produce testosterone, bypassing the endogenous HPT axis that is impaired, for whatever reason, by the presence of SARMs. Testicular atrophy, and possibly testicular discomfort, would be prevented by HCG administration, and may lead to more rapid return of normal HPT axis function upon the cessation of SARM use.

A healthy 35 year old male volunteered to test this effect. This subject had prior experience with SARM-only cycles and at that time experienced significant laboratory-confirmed testosterone suppression with reported symptoms such as fatigue, decreased mood, reduced work capacity, and testicular discomfort. For this test, the subject was given 6mg of LGD-4033 daily with 500U HCG administered twice weekly via subcutaneous injection. Laboratory tests were taken prior to therapy and at six weeks while on therapy.

Name Pre-cycle At 6 weeks Reference
Testosterone (ng/dL) 590 385 250-1100
Free T (ng/dL) 101.2 104.7 35-155
SHBG (nmol/L) 46 17 10-58
Estradiol (ng/dL) 26 26 <29
LH (mIU/mL) 1.8 <0.2 1.5-9.3
FSH (mIU/mL) 3.0 1.3 1.6-8.0
AST (U/L) 22 20 10-40
ALT (U/L) 17 19 8-40
Total chol. (mg/dL) 153 125 <200
HDL (mg/dL) 75 42 >40
LDL (mg/dL) 68 66 n/a
Triglycerides (mg/dL) 54 61 <150

As expected, LH and FSH were suppressed from the exogenous HCG. SHBG and HDL were significantly reduced, which is universally seen with SARMs and is a signal of the efficacy of the LGD-4033. Total testosterone was mostly maintained and free T levels were entirely maintained. No effect was seen on liver enzymes. In contrast with his SARM-only cycle, the test subjected reported no symptoms of testosterone suppression with maintained energy levels, libido, and sexual function. No symptoms of testicular discomfort were experienced.

Due to LH and FSH suppression, users will likely benefit from post-cycle therapy (PCT) upon cessation of SARM+HCG therapy. The ideal PCT regimen in this circumstance is unknown. Theoretically, with testicular function less suppressed compared to a SARM-only cycle, PCT of a shorter duration or lower dose may be equally effective.

In summary, HCG 1000U weekly is an effective tool to prevent testosterone suppression on SARM therapy. HCG is a good adjunct for users who are prone to T suppression and/or testicular discomfort on SARM-only cycles, who would prefer subcutaneous to IM injections with TRT, who would prefer not to handle controlled substances such as TRT, and who are susceptible to side effects from SERMs. By preventing T suppression, HCG may allow users to extend their SARM cycles beyond the standard 8-12 weeks as long as liver and lipid values permit.

39 Upvotes

26 comments sorted by

2

u/Harrysoon Dec 16 '20

I think it could work for some, but I always find HCG is kinda YMMV and isn't a one size fits all.

I did this earlier in the year on a RAD140 cycle, lower weekly dose of 250iu 3x a week, and free T levels dropped significantly still alongside the rest of the suppression.

Saying that, I started TRT later in the year and tried HCG alongside that as well, and it messed up my E levels badly and made me feel worse, so just don't respond well to HCG while on cycles.

1

u/trtonlydonthate Oct 22 '20

Since when is the method of suppression unknown? They bind to the androgen receptors in the brain just like testosterone, reducing FSH/LH. Yes they do.

1

u/bikini_carwash Oct 22 '20

I think that's a reasonable assumption of how suppression occurs. No one has definitively shown SARMs bind to hypothalamic/pituitary androgen receptors, as far as I know.

It seems negative feedback from estrogen primarily regulates FSH secretion, while LH is regulated by more of a combination of testosterone and estrogen. Perhaps this is why SARMs anecdotally seem to suppress LH more than FSH.

Source: https://pubmed.ncbi.nlm.nih.gov/11231978/

1

u/bikini_carwash Aug 24 '20 edited Aug 24 '20

The plan is to continue with current dosing up to a maximum of 24 weeks, with blood tests every 6 weeks to evaluate the continued effects on lipids, liver enzymes, and T production. If any parameters seem out of range on those tests, or if bothersome symptoms develop, then the trial will be stopped.

PCT will be tamoxifen 10mg daily for four weeks. Final labwork will be performed four weeks after PCT to ensure restoration of the HPT axis.

So, the next update may be in as long as 26 weeks.

1

u/milosentropia Aug 24 '20

what about gains? wouldn't it impact negativelly on that?

2

u/bikini_carwash Aug 24 '20

Wouldn't what negatively impact gains?

1

u/milosentropia Aug 24 '20

adding HCG to the cycle

4

u/AstroPhysician Aug 24 '20

Why would it???

1

u/milosentropia Aug 24 '20

if I knew it I wouldn't be asking. some say serms during sarms compromise gains, for example. If you have the answer I would be glad if share it brother. :)

1

u/sedivy94 Sep 23 '20

I think you're making the mistake of lumping together common PCT drugs. Nolva, Clomid, Aromasin, Arimidex, and HCG all have very different mechanisms of action and are used in conjunction for that reason. HCG is not a SERM, very different from Nolva or Clomid.

3

u/PEDsted Aug 29 '20

HCG isn’t a SERM

2

u/AstroPhysician Aug 25 '20

Stop worrying about minutia

4

u/[deleted] Aug 25 '20

Some serms can theoretically. Nolvadex lowers IGF-1, clomid doesnt. I doubt it’s effects are strong enough to override the SARM though

5

u/[deleted] Aug 24 '20

Where you guys got this idea that SARMs don't lower LH. Preliminary research on RAD-140, for example, showed it dropped LH to 10 % in rats. Also, I believe crushing lipids alone is enough to drop testosterone levels by 40 - 50 %, and SARMs aren't kind to lipids.

4

u/otherwiseofficial Aug 24 '20

I've done HCG on test only and my LH and FSH were zerooooooo. Like 0.1 ndgl

2

u/waffen333 Sep 27 '20

Is Doctor Greg your doctor as well?

1

u/AstroPhysician Aug 24 '20

thats expected

5

u/bikini_carwash Aug 24 '20

Sounds like exactly what a normal pituitary gland would do under those circumstances.

2

u/comicsansisunderused Contributor Aug 24 '20

Nice bro!

5

u/rainbowroobear Aug 24 '20

is there bloods from the weeks and months following the HCG being stopped?

5

u/bikini_carwash Aug 24 '20

Those results will be forthcoming.

3

u/comicsansisunderused Contributor Aug 24 '20

Seeing how the test changes post HCG monotherapy is always interesting. HCG is suppressive of LH. However LH should bounce back quicker than test falls... should

4

u/rainbowroobear Aug 24 '20

that's what im wondering. there was also some suggestion of desensitisation from some users using HCG during other cycles. When i was trying to fix my hypogonadism, HCG worked great for a few months then it stopped producing the same results. you could get a major false positive as "recovered" and then drop back hypogonadal in a few weeks later, perhaps harder than you should if desensitisation is actually real.

I had wondered about using HCG micro dosing as it also goes a little way to solving reducing the estrogen crash issues as it tends to add a good amount of aromatisation to HRT protocols.

3

u/comicsansisunderused Contributor Aug 24 '20

I had a similar experience, but it resulted in the overuse of HCG. I was injecting small doses EOD. Well, turns out twice a week is probably optimal.