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Thread: HRT: Basics on hormone replacement therapy

  1. #1
    Iron Addict marcus300's Avatar
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    Default HRT: Basics on hormone replacement therapy

    Here is an article I wrote a while back for another site, it may help some-

    Hrt- Info
    As we grow older our testosterone levels start to slowly decline while estrogen levels increase, In some bodybuilders this process happens alot sooner than others because of the continuation of attacking your HPTA, Continually shutting your system down for weeks on end then trying to recover it isnt an ideal approach, over time this will effect your own natural production of test, In many cases the damage occurs to your HPTA and there is only one option which comes alot sooner in life than it should - HRT.

    With HRT we try to balance our sex hormones; testosterone, estrogen and progesterone to the same levels that they were at in our mid- twenties, symptoms of lower than normal test are; muscle loss,fat gain, gyno,depression,anger, low libido, erection problems,testicle shrinkage,energy level,low self esteem, irritability, unusual sleeping pattern and relationship problems, infact every part of your life is effected and the day to day living becomes a toil.

    First, blood tests need to be done to estabolish how your T- levels and some medical and lifestyle background will determine why your sex hormones are out of balance. A blood test needs to find the levels of your free and total testosterone,estradiol,total estrogens ,LH, IGF-1, prolaction, DHEA, and several other hormones,

    The blood test will determine what type of treatment is needed for balancing the hormones best, not all people should go straight on testosterone replacement therapy, with Andropause (male menopause) our bodys go through a slow process where free testosterone levels slowly start to decline, if you were to go straight onto testosterone replacement it could potentially shut down your HPTA fully when it was still producing a certain amount, careful planning will help find which treatment is best for your individual problem. Bodybuilders who go straight onto test replacement may find that they need to stay on it for the rest of their life so sometimes other methods might suit the person better.

    When the testes fail to produce Test and men have primary hypogonadism or hypogonadotropic hypognadism Test replacement is the answer, there are a few methods what could solve the problem but knowing the risks what come with each treatment will help to understand the benefits to risk ratio. We produce around 4-7mg of Test per day in a circular pattern with Max levels attained in the early morning and min levels in the evening. Mimicking and stabilizing these levels would be the best approach for treatment.

    The best course of treatment would be a therapy what maintains serum concentrations of the hormone without giving significant side effects. many different treatments are available including injectables, tablets and transdermal systems. Within bodybuiling world many go with injection. Estered forms of Test are commonly used with injection of 200-300mg every 14 days (long esters) or shorter ester's can be used but frequent injection normally put alot of BB's off.

    Normally these injection will be good enough to produce enough serum Test levels, many need to adjust the dose or frequency to suit but with more mg comes more possible sides so be careful. Constant monitoring of Test levels to make sure they are in the normal ranges is needed, also men over 40yrs old should have their prostate check on a regular basis. Other sides of such treatment may be lipid abnormalities (reduce HDL,LDL & elevation in blood viscosityl), polycythemia,sleep apnea, and prostate changes.

    In many cases when treatment is implemented sides of andropause will stopped. many will feel a new person and a feeling of well being beholds them. There are positive changes in body composition to more lean mass and decrease BF.

    Bodybuilders who are constantly shutting down the HPTA and using AAS over many years have a great potential of damaging their own systems. I've seen so many young guys who are on HRT due to AAS, please think very carefully because what you may do now at this stage could effect your in later life or even sooner. Because we use such higher than normal dosages of Test we get accustomed to the great feeling it produces and when we come off many suffer. I've not known one long term bodybuilder not suffer some of the sides mentioned in this thread. If AAS is the direction your going to achieve your goals makes sure you do it as healthy as possible, spend as little as possible on cycle to achieve your goals and try and keep shutdown to a minimum time. Remember it easier to recover from a short shutdown than it is longer ones.
    marcus

  2. #2
    Iron Addict marcus300's Avatar
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    If your intrested- bump
    marcus

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    Amateur Threat Ninja Loco's Avatar
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    We are.


    This is excellent information
    "Life is about choices: tap, nap, or SNAP!" ~ Future UFC Lightweight Champion Marcus Hicks

  4. #4
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    I'm definitely looking into HRT. I'll probably wait till i'm 45 though.

  5. #5
    Iron Addict marcus300's Avatar
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    Andriol and proviron study for HRT
    This is an intresting study and well worth reading if HRT may be an issue, i posted this on another board and feel some might benefit from reading it, very useful information-

    Historical Factors

    One hundred and fifty years ago, a German Professor called Berthold showed that transplant of a cockerel's testis prevented atrophy of the comb after castration. This first clearly documented case of successful hormone replacement therapy inaugurated a century of attempts to use testicular transplants and extracts to rejuvenate the male, which has resulted in the dubious "monkey-gland" image of testosterone treatment which persists to this day.

    It was only with the isolation and synthesis of testosterone 60 years ago that effective replacement therapy with this hormone became possible. Testosterone was immediately introduced into clinical medicine either as pellets of the crystals, which is still the most effective and convenient form of treatment available so far, or as the oral form methyl testosterone, which unfortunately is toxic to the liver and heart, and has adversely coloured the thinking of the two intervening generations of physicians. It has only been recently that tests have been made available to measure levels of testosterone in samples of blood. Prior to this, there was no way of diagnosing by analysis whether a man was suffering from the Andropause. Such analytical methods now make dignosing the Andropause a simple matter.

    Within the English speaking world there is not the eqyivalent of a gynaecologist for mens' health issues. There are a number of "Andrologists" who specifically deal in mens' health on the Continent of Europe, where the diagnosis and management of the Andropause is taken more seriously.

    Furthermore, unlike the situation for womens health, there has been a chronic lack of interest and very little funding for mens' health. The disparity remains as great as ever, even now.

    Medical Factors

    In 1944 what is now described as the male menopause, or andropause, was reported in a key article in The Journal of the American Medical Association by two American doctors, Carl Heller and Gordon Myers. They compared the symptoms with those of the female menopause, and undertook a blind controlled trial showing the effectiveness of testosterone treatment. Even after this excellent article, the condition and treatment with testosterone in general, other than in obvious cases of testicular insufficiency, failed to achieve general acceptance.

    400 men attending a private clinic in London complaining of symptoms which they or their GPs attributed to the male menopause, were studied. The nature of the complaints and their frequency were remarkably similar to those reported in the Heller and Myers study.

    These included fatigue 82%, depression 70%, irritability 61%, reduced libido 79%, awareness of premature ageing 43%, aching and stiff joints in the hands and feet 63%, increased sweating especially at night 53%, and classic hot flushes 22%. Last but not least, 80% suffered erectile dysfunction, reduced early morning erections often being an early warning sign.

    The age range of 31-80 (mean 54) was wider than that of the menopause in women (45-55) reflecting the importance of the wide range of factors influencing its onset. The overlapping associated factors appeared to be psychosocial stress (59%), alcohol (35%), injuries or operations, particularly vasectomy, (32%), medication (31%), smoking (26%), obesity (22%), infections (such as the orchitis caused by mumps and glandular fever, and prostatitis) (11%) and impaired descent of the testes (5%).

    The hormonal picture clearly demonstrated the reasons why this condition remains undiagnosed. Total testosterone, which is all that is usually measured in men complaining of these symptoms, was only low in 13% of cases. However, more detailed blood analyses showed that the Free Androgen Index (FAI) obtained by dividing total plasma testosterone level by that of the important carrier protein, Sex Hormone Binding Globulin (SHBG), was decreased in 74%, mainly because of high levels of the latter.

    One obvious difference between the female menopause and the andropause is the contrast between the abrupt fall in oestrogen levels in women, compared to the slow decline of total plasma testosterone levels with age in healthy men. However, there is a range of factors which can cause a relative rather than absolute deficiency of testosterone in men from mid-life onwards. Free, biologically active, testosterone in the blood and tissues decreases markedly with age, mainly because of the rising levels of the binding protein SHBG in the blood, which stops the testosterone getting into the cells to exert its many important functions. There is also decreased production of testosterone by the testes, because of stress, illness, low fat diets, and altered hormonal balance in the body due to ageing and other life events.

    The findings in a cross-sectional survey of 1,000 men in London, indicated that impairment of the many actions of testosterone crucial to both vitality and virility causes symptoms of the Andropause to emerge when the FAI falls to a critical level of around 50%, or the total testosterone level is subnormal.

    There was a significant dose related relief of the andropausal symptoms with two oral forms of treatment (Restandol [Organon], Pro-Viron [Schering]), and especially with testosterone implants. The safety of the forms of testosterone treatment used in this carefully monitored group of men, particularly in relation to the heart, liver and prostate gland was confirmed by detailed serial tests at periods of three to six months for up to five years.

    Image Factors

    There are a variety of what can best be described as image problems connected with the male menopause and the use of testosterone to treat it. Firstly the name of the condition, even if dignified with the medical title of Andropause, appears an unacceptable threat to masculinity, the "macho" self-image. It is seen as their end of life as potent males, as leaders and as lovers. While women are willing to discuss with each other, and with their medical advisers, their menopausal symptoms and HRT to mitigate them, men are remarkably reluctant to turn to either unless desperate.

    Secondly, the condition is often incorrectly confused with the psychological traumas of the "Male Mid-life Crisis". Thirdly, because of reports of the abuse of anabolic steroids by athletes, testosterone has suffered a very bad press. Together with deliberately exaggerated horror stories of their physical and psychological dangers, which have filled the newspapers at increasingly frequent intervals over the last twenty years, this "pharmacological arms race" has damaged testosterone's image.

    Fourthly, there is the public perception of testosterone as the hormone responsible for undesirable male traits such as aggression and hypersexuality. The unfounded fear that such treatment will "bring out the beast in men", and turn them into rapacious monsters as portrayed by Jack Nicholson in the recent film "Wolf", holds many andropausal men, who unlike him cannot claim to have "retained my testosterone longer than most males", back from treatment.

    Lastly, there is the same argument that women had to overcome in relation to HRT, that it was flying in the face of nature and they should learn to grow old gracefully. Given the wide range of benefits to psyche, soma and sexuality that oestrogens are being shown to offer postmenopausal women in adding life to years as well as years to life, increasing numbers see it more as modern science giving nature a helping hand. It seems likely that men will come to the same view of living their lives like alk****e batteries, going full charge to the end.



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    Key Points on TRT in the treatment of the Andropause
    --------------------------------------------------------------------------------
    Reduced Testosterone activity is common in men from the age of 40 onwards.
    This causes the loss of energy, libido and potency which make up the "Male Menopause" or "Andropause".
    The Condition can usually be helped by carefully monitored Testosterone Replacement Therapy (TRT).
    TRT is as safe and effective as Hormone Replacement Therapy (HRT) for women.
    In addition to TRT, a wide range of other treatments to restore potency are available, especially Viagra.
    TRT is an important form of preventive medicine, probably slowing the ageing process in men.

    Testosterone Replacement Therapy for Men (TRT)

    TRT - HRT for men using Testosterone, has been shown to be dramatically effective in relieving symptoms and restoring drive, health, potency, and a sense of renewed vitality and virility when the right preparations are given to the right patients in the right doses at the right time.

    To ensure its safety and effectiveness however it is essential that a full assessment or "work-up" of each patient is carried out before hormone replacement is started, and that the results of treatment are carefully monitored. For this purpose careful history-taking and examination and blood tests need to be carried out.

    Both to establish the diagnosis and to monitor the treatment properly, laboratory measurements of the sex hormones and the complex range of factors regulating their action, together with tests of blood fat, liver, kidney, and prostate function and haematology profile, all need to be checked before treatment and at each follow-up assessment.

    TRT is usually given in tablet or capsule form for the first three to six months. It can then be continued if necessary by mouth, transdermally, by injection, or by implantation of pellets of fused testosterone crystals into the buttock, under a local anaesthetic, at six monthly intervals.

    Availability of Testosterone Preparations

    In many parts of the world, the two main safe oral preparations, Testosterone Undecanoate (Andriol or Restandol made by Organon) and Mesterelone (Pro-Viron made by Scherring) are available, as well as Testosterone Pellet Implants, also made by Organon. Transdermal Testosterone in the form of body or scrotal patches or creams is also available in most countries. In the USA, Testosterone is mainly available either by patches, or injectable forms such as Testosterone Enanthate, though it is hoped that Andriol may soon also be available there.

    Availability of treatment


    The availability of testosterone treatment is rapidly increasing world-wide, as more doctors become convinced of the benefits and safety of TRT for men. One of the aims of the Andropause Society is to accelerate this process by making doctors more aware of the problems associated with the Male Menopause, or andropause, and informing them of the latest research in its favour and providing training for them via the Web using the latest video conferencing technology.

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    Potency Problems Page
    --------------------------------------------------------------------------------

    This is the commonest presenting problem in male sexual dysfunction clinics and peaks at the time when the andropause appears, that is the mid-forties onwards. It is a major health problem which is seldom adequately investigated or treated.

    The Mechanics of Erection

    Man's ability to have an erection, which has been worshipped from the earliest of times, is actually a recurring miracle of hydraulic engineering. It is brought about by a complex series of chemical changes and nerve reflexes, which work together to increase the amount of blood flowing into the penis and temporarily decrease the amount going out. Two elongated blood sacks, the corpora cavernosa, become engorged and create the erection. This event, which is achieved with effortless and sometimes embarrassing ease in the teens and twenties, usually becomes a more difficult feat in the thirties and forties, can be variable in the fifties and sixties, and is often a disappointingly brief and infrequent wonder in the seventies and beyond, especially in the 'hormonally challenged' andropausal male.

    Testosterone and Erectile Function

    Though it is difficult to say precisely what part testosterone plays in helping to produce erections, it certainly both primes the penis and triggers the chain of events which bring an erection about. It is surprising, but gratifying, how often when adequate testosterone therapy is given, all the symptoms of the andropause disappear within a few weeks or months, including erectile difficulties, particularly when other factors contributing to its onset or continuation are dealt with.

    A statistically highly significant improvement in erectile function occurred in over 70 per cent of 1000 cases treated with a variety of different forms of testosterone. This was particularly marked with the more powerful oral preparation, Restandol (Andriol), which sometimes needed to be given in high but safe doses, and with the testosterone pellet implants.

    Though this use of testosterone to help erection problems is controversial and not acknowledged by some authorities, which say it only increases frustration without giving back the means to perform, this is certainly not the experience in this large group of patients. The efficiency of testosterone in restoring potency is a common experience with doctors prepared to give it an adequate trial.

    It was even recognised over 50 years ago in the article on the 'male climacteric' by Drs Heller and Myers in an article on"The Male Climacteric" in JAMA in 1944. They found that erectile function returned in nearly all of their testosterone deficient patients when they gave the hormone and went away again when they stopped.

    Even though it is more difficult to restore function than desire, unless the source of the problems is obviously psychological or mechanical, it seems logical to investigate the testosterone balance of the patient, and restore it to normal as the first stage of treatment. Even if erections are not greatly improved by this alone, libido and confidence usually are. The most commonly used methods such as penile injections of prostaglandins, as in Caverject, then seem to work much better. Recent experience at in London has shown this to be particularly true when Viagra and Testosterone are combined to cure over 98% of impotence problems.
    marcus

  6. #6
    Juggernaut Brutal Master's Avatar
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    any health issues with being on HRT?
    "Feel ill as fuck - not sure if it is protein powder or tren?"-bigdog123

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    What about hrt and kids? Can i get my wife pregnant while on hrt?

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    Super Moderator heavyiron's Avatar
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    I came across this graph showing what Testosterone levels of healthy men of a particular age group should be because most reference ranges used by doctors today used sick or very elderly men to create the ranges.

    FIG. 1. TT vs. age (natural log scale for all observations). Linear trajectories for 20 randomly chosen subjects are plotted (thin lines), demonstrating the substantial intersubject variation in log T values and trends over time. A nonparametric, locally weighted regression smooth (thick line) depicts the linear decline in log T values with age over all observations, which is generally outstripped by within-subject longitudinal decline. To convert TT from nanograms per deciliter to nanomoles per liter, multiply by 0.0347.

    http://jcem.endojournals.org/cgi/content/full/92/2/549
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    All posts are for entertainment and may contain fiction. Consult a doctor before using any medication.


  9. #9

    Default Help low "T" high Red count

    I have low "T" levels, actually the free is 144 ng/dl, it should be between 300 -1,000 ng/dL for a man my age (49). I was put on Test injections every other week of 150mg. I feel better now, however, it seems to decline within 9 days. I asked my doctor to increase my dosage to fix this.

    The doctor did a new blood test and found my Red blood count is now to high at "18.6" and is going to reduce my therapy to 50mg weekly, even though my levels are below normal.

    So my question is how can I reduce my Red blood count?
    So that I can get my doctor to raise my levels up to near normal.

  10. #10
    Super Moderator heavyiron's Avatar
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    Quote Originally Posted by RMINER View Post
    I have low "T" levels, actually the free is 144 ng/dl, it should be between 300 -1,000 ng/dL for a man my age (49). I was put on Test injections every other week of 150mg. I feel better now, however, it seems to decline within 9 days. I asked my doctor to increase my dosage to fix this.

    The doctor did a new blood test and found my Red blood count is now to high at "18.6" and is going to reduce my therapy to 50mg weekly, even though my levels are below normal.

    So my question is how can I reduce my Red blood count?
    So that I can get my doctor to raise my levels up to near normal.
    Have you tried giving blood?
    All posts are for entertainment and may contain fiction. Consult a doctor before using any medication.


  11. #11

  12. #12

    Thumbs up Andropause is treatable but not the HRT way

    The Dangers of Exogenous (external and synthetic)
    Testosterone Replacement Therapy

    One of the most undesirable side effects of exogenous testosterone replacement therapy is the shrinkage of the male genitals, the penile and testes. The medical term for the condition is "testicular atrophy". With prolonged usage, your penis will shrink to the size of your little finger.

    Now imagine this. You get a high sex drive with the testosterone replacement therapy, yes, but your erected penis is the size of your thumb. Not a very good scenario, isn't it?

    As a matter of fact, the renown Mayo Clinic lists the following side effects with exogenous (external and synthetic) testosterone replacement therapy:

    * Cause skin reactions
    * Cause fluid retention
    * Cause baldness
    * Cause or aggravate sleep apnea (brief, repeated cessation of breathing during sleep)
    * Stimulate non cancerous (benign) growth of the prostate and cause or worsen urinary symptoms
    * Stimulate growth of prostate cancer that's already present
    * Enlarge breasts (Gynecomastia)
    * Stimulate growth of breast cancer that's already present
    * Cause testicle shrinkage (Testicular atrophy)
    * Limit sperm production (Infertility)
    * Stimulate excess blood production (Polycythemia)

    I'm sure you agree with me. Its not pretty. However the number of prescriptions of testosterone replacement therapy has increase over the years. And the primary reason is I believe the lack of emphasis by doctors and pharmaceutical companies on the negative side effects of the treatment.

  13. #13

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    I was having this Andropause condition since I hit the age of 52. I noticed my desire for sex had greatly diminished and I was alarmed. I had many of the outward signs of the condition but was not aware of it, until I met a herbalist friend.

    He introduced me to a herb called Eurycoma Longifolia Jack also know as Tongkat Ali and also by the name Pasak Bumi. I was at first skeptical but after he showed me the literature and his consumption of it, I believed and trusted him. I consumed this extract for several days and miraculously I began to notice that I had regained my 'youth' again. In short the herbal substance was also an aphrosisiac. He strongly advised me against homonal replacement theraphy (HRT) as it has many side effects.

    Becareful there are many web sites which offer the same product but they have hidden substances which is detrimental to your health. It is safest to have a knowledgeable person to guide you on the intake of such potent herbs.

  14. #14
    Super Moderator heavyiron's Avatar
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    Quote Originally Posted by gungho9 View Post
    The Dangers of Exogenous (external and synthetic)
    Testosterone Replacement Therapy

    One of the most undesirable side effects of exogenous testosterone replacement therapy is the shrinkage of the male genitals, the penile and testes. The medical term for the condition is "testicular atrophy". With prolonged usage, your penis will shrink to the size of your little finger.

    Now imagine this. You get a high sex drive with the testosterone replacement therapy, yes, but your erected penis is the size of your thumb. Not a very good scenario, isn't it?

    As a matter of fact, the renown Mayo Clinic lists the following side effects with exogenous (external and synthetic) testosterone replacement therapy:

    * Cause skin reactions
    * Cause fluid retention
    * Cause baldness
    * Cause or aggravate sleep apnea (brief, repeated cessation of breathing during sleep)
    * Stimulate non cancerous (benign) growth of the prostate and cause or worsen urinary symptoms
    * Stimulate growth of prostate cancer that's already present
    * Enlarge breasts (Gynecomastia)
    * Stimulate growth of breast cancer that's already present
    * Cause testicle shrinkage (Testicular atrophy)
    * Limit sperm production (Infertility)
    * Stimulate excess blood production (Polycythemia)

    I'm sure you agree with me. Its not pretty. However the number of prescriptions of testosterone replacement therapy has increase over the years. And the primary reason is I believe the lack of emphasis by doctors and pharmaceutical companies on the negative side effects of the treatment.
    This is just flat out wrong. Your penis does not shrink when using HRT. The only thing that can shrink is your testicles. If you use HCG like most doctors prescribe when on HRT then your testicles will remain the same or even increase in size.
    All posts are for entertainment and may contain fiction. Consult a doctor before using any medication.


  15. #15

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    Quote Originally Posted by gungho9 View Post
    It is safest to have a knowledgeable person to guide you on the intake of such potent herbs.
    So let me guess....you are such a person and we should let you guide us? Oh, and I'm sure you're not selling anything here either.

    You pulled that quote regarding penile shrinkage out of your arse. Saying things like this with the expectation that people here are going to believe you is nothing short of insulting.

  16. #16

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    What is HCG?

  17. #17
    Super Moderator heavyiron's Avatar
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    Quote Originally Posted by Skoob View Post
    What is HCG?
    Human chorionic gonadotropin (hCG) is a glycoprotein hormone produced in pregnancy that is made by the the developing embryo soon after conception and later by the syncytiotrophoblast (part of the placenta). Its role is to prevent the disintegration of the corpus luteum of the ovary and thereby maintain progesterone production that is critical for a pregnancy in humans. hCG may have additional functions; for instance, it is thought that hCG affects the immune tolerance of the pregnancy. Early pregnancy testing, in general, is based on the detection or measurement of hCG. Because hCG is produced also by some kinds of tumor, hCG is an important tumor marker, but it is not known whether this production is a contributing cause or an effect of tumorigenesis.
    Contents



    Structure

    Human chorionic gonadotropin is a glycoprotein composed of 244 amino acids with a molecular mass of 36.7 kDa. Its total dimensions are 75×35×30 angstroms (7.5×3.5×3 nanometers).



    It is heterodimeric, with an α (alpha) subunit identical to that of luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), and β (beta) subunit that is unique to hCG.
    • The α (alpha) subunit is 92 amino acids long and has dimensions 60×25×15 angstroms (6×2.5×1.5 nm).

    • The beta subunit of human chorionic gonadotropin is encoded by six highly-homologous genes that are arranged in tandem and inverted pairs on chromosome 19q13.3 - CGB (1, 2, 3, 5, 7, 8).
    The two subunits create a small hydrophobic core surrounded by a high surface area-to-volume ratio: 2.8 times that of a sphere. The vast majority of the outer amino acids are hydrophilic.

    Function

    Human chorionic gonadotropin interacts with the LHCG receptor and promotes the maintenance of the corpus luteum during the beginning of pregnancy, causing it to secrete the hormone progesterone. Progesterone enriches the uterus with a thick lining of blood vessels and capillaries so that it can sustain the growing fetus. Due to its highly-negative charge, hCG may repel the immune cells of the mother, protecting the fetus during the first trimester. It has also been hypothesized that hCG may be a placental link for the development of local maternal immunotolerance. For example, hCG-treated endometrial cells induce an increase in T cell apoptosis (dissolution of T-cells). These results suggest that hCG may be a link in the development of peritrophoblastic immune tolerance, and may facilitate the trophoblast invasion, which is known to expedite fetal development in the endometrium.[1] It has also been suggested that hCG levels are linked to the severity of morning sickness in pregnant women.[2]
    Because of its similarity to LH, hCG can also be used clinically to induce ovulation in the ovaries as well as testosterone production in the testes. As the most abundant biological source is women who are presently pregnant, some organizations collect urine from pregnant women to extract hCG for use in fertility treatment.
    Human chorionic gonadotropin also plays a role in cellular differentiation/proliferation and may activate apoptosis.[3]

    Testing

    Levels of hCG may be measured in the blood or urine. Most commonly, this is done as a pregnancy test, intended to indicate the presence or absence of an implanted embryo. Testing for hCG may also be done when diagnosing or monitoring germ cell and trophoblastic tumors.



    Most tests employ a monoclonal antibody (MAb), which is specific to the β-subunit of hCG (βhCG). This procedure is employed to ensure that tests do not make false positives by confusing hCG with LH and FSH. (The latter two are always present at varying levels in the body, whereas the presence of hCG almost always indicates pregnancy.)
    • The urine test may be a chromatographic immunoassay or any of several other test formats, home-, physician's office-, or laboratory-based.[4] Published detection thresholds range from 20 to 100 mIU/ml (milli International Units per milli-liter), depending on the brand of test.[5] Early in pregnancy, more accurate results may be obtained by using the first urine of the morning when hCG levels are highest. When the urine is dilute (specific gravity less than 1.015), the hCG concentration may not be representative of the blood concentration, and the test may be falsely negative.

    • The serum test, using 2-4 mL of venous blood, is typically a chemiluminescent or fluorimetric immunoassay[4] that can detect βhCG levels as low as 5 mIU/ml and allows quantitation of the βhCG concentration. The ability to quantitate the βhCG level is useful in the monitoring germ cell and trophoblastic tumors, followup care after miscarriage, and in diagnosis of and follow-up care after treatment of ectopic pregnancy. The lack of a visible fetus on vaginal ultrasound after the βhCG levels have reached 1500 IU/ml is strongly indicative of an ectopic pregnancy.
    Gestational trophoblastic disease like Hydatidiform moles ("molar pregnancy") or Chroiocarcinoma may produce high levels of βhCG (due to the presence of syncytialtrophoblasts- part of the villi that make up the placenta) despite the absence of an embryo. This, as well as several other conditions, can lead to elevated hCG readings in the absence of pregnancy.
    hCG levels are also a component of the triple test, a screening test for certain fetal chromosomal abnormalities/birth defects.

    hCG Levels




    The following is a list of serum hCG levels. Note that these are merely typical values--a given woman's values may not fall within these ranges. (LMP = since last menstrual period).
    • 3 weeks LMP: 5 - 50 mIU/ml
    • 4 weeks LMP: 5 - 426 mIU/ml
    • 5 weeks LMP: 18 - 7,340 mIU/ml
    • 6 weeks LMP: 1,080 - 56,500 mIU/ml
    • 7 - 8 weeks LMP: 7, 650 - 229,000 mIU/ml
    • 9 - 12 weeks LMP: 25,700 - 288,000 mIU/ml
    • 13 - 16 weeks LMP: 13,300 - 254,000 mIU/ml
    • 17 - 24 weeks LMP: 4,060 - 165,400 mIU/ml
    • 25 - 40 weeks LMP: 3,640 - 117,000 mIU/ml
    • Non-pregnant females: <5.0 mIU/ml
    • Postmenopausal females: <9.5 mIU/ml
    Tumor marker

    The β subunit of human chorionic gonadotropin is secreted also by some cancers including choriocarcinoma, germ cell tumors, hydatidiform mole formation, teratoma with elements of choriocarcinoma (this is rare), and islet cell tumor. For this reason a positive result in males can be a test for cancer, The normal range for men is between 0-5 IU/ml, although cancer should not automatically be suspected if the level is <30.
    Main article: tumor marker

    Use as medication

    Human chorionic gonadotropin is extensively used as a parenteral fertility medication in lieu of luteinizing hormone. In the presence of one or more mature ovarian follicles, ovulation can be triggered by the administration of hCG. As ovulation will happen about 36-48 hours after the injection of hCG, procedures can be scheduled to take advantage of this time sequence. Thus, patients that undergo IVF, in general, receive hCG to trigger the ovulation process, but have their eggs retrieved at about 36 hours after injection, a few hours before the eggs actually would be released from the ovary.
    As hCG supports the corpus luteum, administration of hCG is used in certain circumstances to enhance the production of progesterone.
    In the male, hCG injections are used to stimulate the leydig cells to synthesize testosterone. The intratesticular testosterone is necessary for spermatogenesis from the sertoli cells. Typical uses for hCG in men include hypogonadism and fertility treatment.
    During first few months of pregnancy, the transmission of HIV-1 from woman to fetus is extremely rare. It has been suggested that this is due to the high concentration of hCG, and that the beta-subunit of this protein is active against HIV-1.[6]

    Use in weight loss

    A controversial usage of hCG is as an adjunct to the British endocrinologist Dr. A.T.W. Simeons’ ultra-low-calorie weight-loss diet[7]. Simeons, while studying pregnant women in India on a calorie-deficient diet, and “fat boys” with pituitary problems treated with low-dose hCG, discovered that both lost fat rather than lean (muscle) tissue. He reasoned that hCG must be programming the hypothalamus to do this in the former cases in order to protect the developing fśtus, and proceeded to use low-dose daily hCG injections (125mg) in combination with a customized ultra-low-calorie (500 kcal/day, high-protein, low-carbohydrate/fat) diet to help obese adults lose dramatic amounts of adipose tissue without loss of lean, at a Salvator Mundi International Hospital in Rome, Italy, clinic mainly for celebrities. After Simeons’ mysterious death, the diet started to spread to specialized centers and via popularization by such as the controversial popular author Kevin Trudeau (search for hCG in that article for more details).
    The controversy proceeds from warnings by the Journal of the American Medical Association[8] and the American Journal of Clinical Nutrition[9] that hCG is not safe,[8] indeed ineffective, as a weight-loss[10] aid on its own; yet its usage as cited above to increase testosterone production contradicts this assertion, since much late-life male obesity is associated with estrogen dominance and deficient testosterone in the mis-named, so-called andropause. Furthermore, in the Simeons protocol, it is, as in any diet, the ultra-low-calorie component (caloric deficit) that results in weight loss, if the protocol is followed strictly. hCG’s role is supposedly to trigger the hypothalamic lean-protection mechanisms Simeons thought he saw, thus promoting mobilization and consumption of abnormal, excessive adipose deposits, while protecting normal adipose and lean tissue from being consumed, with the assumption that these protective hypothalamic mechanisms exist in males as well as females, to be acted upon by hCG.

    Use with anabolic steroids

    In the world of performance enhancing drugs, hCG is increasingly used in combination with various anabolic androgenic steroid (AAS) cycles.
    When AAS are put into a male body, the body's natural negative-feedback loops cause the body to shut down its own production of testosterone via shutdown of the hypothalamic-pituitary-gonadal axis (HPGA). High levels of AASs that mimic the body's natural testosterone trigger the hypothalamus to shut down its production of gonadotropin-releasing hormone (GnRH) from the hypothalamus. Without GnRH, the pituitary gland stops releasing luteinizing hormone (LH). LH normally travels from the pituitary via the blood stream to the testes, where it triggers the production and release of testosterone. Without LH, the testes shut down their production of testosterone, causing testicular atrophy.
    In males, hCG mimics LH and helps restore and maintain testosterone production in the testes. As such, hCG is commonly used during and after steroid cycles to maintain and restore testicular size as well as endogenous testosterone production. However, if hCG is used for too long and in too high a dose, the resulting rise in natural testosterone will eventually inhibit its own production via negative feedback on the hypothalamus and pituitary.

    Production

    Like other gonadotropins, hCG can be extracted from urine or by genetic modification. Pregnyl, Follutein, Profasi, and Novarel use the former method, derived from the urine of pregnant women. Ovidrel, on the other hand, is a product of recombinant DNA.

    See also

    References

    1. <LI id=cite_note-0>^ Kayisli U, Selam B, Guzeloglu-Kayisli O, Demir R, Arici A (2003). "Human chorionic gonadotropin contributes to maternal immunotolerance and endometrial apoptosis by regulating Fas-Fas ligand system". J. Immunol. 171 (5): 2305–13. PMID 12928375. <LI id=cite_note-1>^ Askling, J; Erlandsson G, Kaijser M, et al. (1999-12-11). "Sickness in pregnancy and sex of child". The Lancet 354 (9195): 2053. doi:10.1016/S0140-6736(99)04239-7. PMID 10636378. http://www.newscientist.com/article/mg16422174.200.html. Retrieved on 2006-07-13. <LI id=cite_note-Michels-2>^ Michels KB, Xue F, Colditz GA, Willett WC (2007). "Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study". Arch. Intern. Med. 167 (8): 814–20. doi:10.1001/archinte.167.8.814. PMID 17452545. <LI id=cite_note-henry-3>^ a b Richard A. McPherson, Matthew R. Pincus, (2006). Henry's Clinical Diagnosis and Management by Laboratory Methods (21st edition ed.). Philadelphia: Saunders. ISBN 1-4160-0287-1. <LI id=cite_note-4>^ Waddell, Rebecca Smith (2006). "FertilityPlus.org". Home Pregnancy Test hCG Levels and FAQ. http://www.fertilityplus.org/faq/hpt.html. Retrieved on 2006-06-17. <LI id=cite_note-pmid10077570-5>^ Lee-Huang S, Huang PL, Sun Y, Huang PL, Kung HF, Blithe DL, Chen HC (March 1999). "Lysozyme and RNases as anti-HIV components in beta-core preparations of human chorionic gonadotropin". Proc. Natl. Acad. Sci. U.S.A. 96 (6): 2678–81. PMID 10077570. PMC: 15828. http://www.pnas.org/content/96/6/2678.abstract. <LI id=cite_note-6>^ http://www.hcgmedical.com/Simeons.asp <LI id=cite_note-urlCaremark-7>^ a b Fraser L. "Ten Pounds in Ten Days: A Sampler of Diet Fads and Abuse". Health resources special report. Caremark, L.L.C.. https://www.caremark.com/wps/portal/HEALTH_RESOURCES?topic=dietscams. Retrieved on 2009-02-03. <LI id=cite_note-pmid786001-8>^ Stein MR, Julis RE, Peck CC, Hinshaw W, Sawicki JE, Deller JJ (September 1976). "Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study". Am. J. Clin. Nutr. 29 (9): 940–8. PMID 786001. http://www.ajcn.org/cgi/reprint/29/9/940.pdf. Retrieved on 2009-02-03.
    2. ^ Barrett S. "HCG Worthless as Weight-Loss Aid". Diet Scam Watch. dietscam.org. http://www.dietscam.org/reports/hcg.shtml. Retrieved on 2009-02-03.
    All posts are for entertainment and may contain fiction. Consult a doctor before using any medication.


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