by Josh Hodnik
It is estimated that more than 15 million men suffer from hypogonadism (low-testosterone) in the United States. There are two basic categories that hypogonadism falls under:
Primary: The testes are where testosterone is produced in men, and with primary hypogonadism the testes do not function correctly. This condition can be caused by genetic disorders, autoimmune disorders, or liver and kidney disease just to name a few.
Secondary: With this form of hypogonadism the testes still function correctly, but pituitary or hypothalamus dysfunction is the cause of low-testosterone. The hypothalamus produces gonadotropin-releasing hormone, which signals the pituitary to make follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Luteinizing hormone then signals the testes to release testosterone. Somewhere along the way there is a disruption in this signaling process causing secondary hypogonadism.
Testosterone injections, creams, and gels are being prescribed by physicians throughout the country to treat low-testosterone in men. There are even a growing number of clinics that now specialize in treating men that suffer from low-testosterone or low levels of other hormones present in the human body. These hormone replacement clinics are nothing new. In fact, clinics of this nature have been around for decades. They are now marketed in a new way, targeting an aging population that wants to look and feel vibrant again.
There is a negative social stigma attached to testosterone, and this has carried over to much of the medical community. Women that suffer from menopause are generally treated with a synthetic estrogen without question. On the other hand, many doctors are very hesitant in treating men that have low levels of testosterone. Estrogen is the dominant hormone in women, while testosterone is the dominant hormone in men. Estrogen replacement with women is simply restoring the dominant hormone back to a normal level. This is the same with men receiving testosterone replacement when levels are low.
This negative social stigma that I mentioned regarding testosterone has many people quick to point out the dangers that accompany testosterone or steroid use. While these dangers are present, but usually overplayed, the side effects that can come about when low-testosterone goes untreated is not usually considered.
When testosterone levels are less than normal, a man can expect to experience a decrease in muscle mass and strength, increases in body fat, a higher rate of depression, and a decrease in mental capacity. This list could go on and on, but you get the point, low-testosterone is not is not good for mental or physical health in men by any means.
Prescribing synthetic testosterone seems to be the simplest and most direct approach to treating low-testosterone. This is not always the case. While synthetic testosterone would be the best treatment for someone that is affected by primary hypogonadism, this may not always be the best route for someone dealing with secondary hypogonadism. Remember, during secondary hypogonadism the testes are still functioning as they should be. It is the pituitary and hypothalamus that is creating a problem.
When secondary hypogonadism is the cause of low-testosterone, it should not be treated the same as primary hypogonadism. A synthetic testosterone can be used as treatment for primary hypogonadism because the testes will not function properly, but when the problem stems from the pituitary and hypothalamus not releasing LH (luteinizing hormone) and FSH (follicle-stimulating hormone), synthetic testosterone may not be the best answer. When released normally, LH and FSH are responsible for directing the testes to produce testosterone, but when synthetic testosterone is introduced into the body, LH and FSH are suppressed. Many doctors will not even try to determine whether or not a man with low testosterone has the condition of primary or secondary hypogonadism. By not doing this, the patient is stuck with only one option, and that is taking synthetic testosterone, which will lead to infertility in almost every case.
Many times secondary hypogonadism can be treated with HCG alone, and sometimes just taking HCG long enough to create stimulation of LH and FSH over a brief period will lead to normal testosterone levels, even after HCG use ceases. HCG has been a common treatment for bodybuilders coming off of a steroid cycle to stimulate natural testosterone production, which was shuts down during steroid use. It has become so common that HCG is on the banned substance list for most athletic testing agencies, and there have been some suspensions handed out recently in the NFL and MLB for players testing positive for HCG.
Below is a picture to describe some crucial functions of the male testosterone hormone:
The picture above explains that testosterone is crucial to maintain:
1. The distribution of fat
2. The production of red blood cells.
3. The strength of muscles.
4. The density of bone.
There are many different ideas regarding dosage for HCG. When taken after a steroid cycle, many people will dose it as high as 5,000 IUs per week, broken into three different doses. Maybe every two to three days. With this method, the body becomes desensitized very quickly, and the body will stop responding to HCG. This is the reason that this drug has been disregarded as a method to treat low-testosterone for the long term. It was only thought to work for a brief period, and hopefully the pituitary and hypothalamus could take over from there without it. This could be true if the person did not have problems with the release of LH and FSH on a normal basis. When secondary hypogonadism is considered, dosage must be altered quite a bit.
When dealing with long-term treatment, HCG should be dosed at 250-500 IUs three times per week. At this dose the body does not become desensitized as it does with higher doses. The downside to HCG is that it has the ability to raise estrogen levels, but this can be kept in check with an anti-estrogen.
With the stigma that surrounds testosterone, many doctors aren’t as interested in treating low-testosterone as they other conditions. Maybe with an alternative like HCG rather than taking actual testosterone, more doctors will be less hesitant in treating a condition that can cause harm when left untreated. As always, any kind of treatment should be discussed with and monitored by your physician.