How Often to Take HCG on TRT? A ‘Gold Standard’ Treatment

HCG dosing is both an art and a science for someone on testosterone replacement therapy (TRT). It is considered the “gold standard” for maintaining testicular function while on testosterone. It also offers a plethora of other physiologic benefits. However, it is hard to obtain and many clinics cannot offer it as a therapy option. But, those clinics who do offer one of the best adjunct therapies that can be used alongside TRT for health and longevity benefits. 

HCG, also known as Human Chorionic Gonadotropin, is a hormone produced in the placenta of a pregnant female. Using recombinant DNA technology, we can produce a bio-identical version of it in a laboratory. 

HCG mimics the action of luteinizing hormone (LH), which is naturally produced by the pituitary gland, and tells the testicles to produce testosterone (and some sperm). When you inject HCG, the testes “think” that it is LH coming from the brain. So, the gonads keep working. 

Before we delve deeper into HCG and how often to take it on TRT, please note that Lucidity Health offers a series of TRT prescription plans for men along with an option for HCG supplementation. 

We encourage readers who are interested in TRT to reach out to us for more information as it should be prescribed and monitored by a healthcare provider. The information in this article is not a substitute for medical advice and is written for illustrative purposes only. 

What Is the Dosing of HCG?

HCG dosing depends on the patient. This will vary, but typically along with TRT, the dosage begins at 250 iU twice weekly. Some dosing regimens use this same amount but increase the frequency to three or four times per week. Other practitioners might recommend 500 iU two or more times per week. It is truly dependent upon the provider and the patient’s discussion about goals while monitoring effects. 

For men wanting to increase fertility, dosing can get far higher, including up to and above 1000 iU three times weekly. The dosing spectrum is wide and the safety profile is well established. For fertility, other therapies are added to help stimulate full testicular function and sperm production, which is beyond the scope of this article.

Read on for more information about why HCG is such a popular supplement to testosterone replacement therapy. 

Why Take HCG with Testosterone? 

In many cases, HCG helps maintain hormonal balance as it can be understandably beneficial to keep the natural hormonal function of the testes intact. 

Remember that while on TRT the brain will see that levels of testosterone in the body are high, so it mostly shuts down the signal of LH (see above) going to the testes. This can lead to the testicles not working as much as they did before. This results in atrophy of the testicle size in some individuals. Some men do not like this aesthetic change. HCG can help ameliorate this issue.

Another benefit is that HCG helps balance out mood, emotion, and maintains the positive hormonal cascade pathways that occur with natural functioning. This involves the neuro-protective steroids of pregnenolone and DHEA, which correlates to a balanced libido and feelings of well-being.

HCG can also promote spermatogenesis. Although this is the actual job of FSH (Follicle Stimulating Hormone) from the brain, when we stimulate testicular work, we get some sperm production that occurs. It’s all about maintaining the HPT (hypothalamic–pituitary–testicular) axis or connection.

It is known that HCG helps balance the overall hormonal profile while also helping to stabilize mood and energy levels for some men. 

Can HCG be taken instead of testosterone? 

HCG should not be a monotherapy to help raise a man’s testosterone levels. This is true for other therapies as well. The base of the pyramid of men’s health is testosterone. Using HCG or other monotherapies to induce the testicles to work harder can lead to over-stimulation, overload, and eventually refractory (loss of) benefits. If used for fertility purposes, it can be effective, but if the goal is to raise testosterone, then it is not medically sound. Any clinic or practitioner that does so is not well versed in men’s health and testosterone regulation. Here are the reasons that HCG should not be used in the place of testosterone:

1. It bypasses natural pituitary regulation

HCG mimics LH but does not replace FSH, which is also produced by the pituitary. Without FSH stimulation, sperm production and overall testicular health may still decline over time.

2. It can cause hormone imbalance

HCG can increase testosterone and, by conversion, estradiol, leading to potential side effects like water retention, gynecomastia, or mood swings if not balanced properly.

3. It doesn’t address underlying hypogonadism causes

If the issue is central (pituitary or hypothalamic), HCG may not fix the underlying problem. If the issue is testicular, the testes might not respond effectively anyway.

4. It’s best used as an adjunct, not a replacement

HCG is often combined with TRT to preserve testicular size, fertility, and intratesticular testosterone while maintaining the benefits of stable serum testosterone from replacement therapy.

In short: HCG alone can temporarily raise testosterone, but it’s not a comprehensive or sustainable replacement for physiologic regulation or full hormone therapy.

How Often Should You Take HCG on TRT?

HCG is typically administered as a subcutaneous injection, with doses ranging from 500 to 2,000 IU per week, divided into multiple injections based on the protocol and individual response. It has a half-life of roughly three days, so injecting twice weekly is usually sufficient to maintain stable levels. HCG is often initiated alongside testosterone replacement therapy (TRT) to help preserve testicular function and prevent testicular shrinkage or suppressed sperm production from the start of treatment.

Mechanism of Action of HCG

HCG is a glycoprotein hormone that mimics luteinizing hormone (LH) and primarily acts by binding to LH/hCG receptors, G-protein-coupled receptors found in the gonads. 

In men, HCG binds to LH/HCG receptors on testicular Leydig cells, activating adenylate cyclase. This supports an increase in cyclic AMP. The result is the stimulation of testosterone production from cholesterol, which helps maintain endogenous testosterone levels and support spermatogenesis, helping maintain or bolster fertility. 

HCG contributes to testosterone replacement therapy by mimicking LH. A typical HCG treatment regimen typically helps sustain receptor activation without excessive estrogen production via testosterone aromatization. 

Read on for more information about who HCG may be right for. This is both for individuals considering TRT and whether HCG may be needed along with it and for those already on TRT who may want to add HCG treatment to counteract the side effects of TRT. 

Do You Need HCG on TRT?

Men may want to consider using HCG if one or more of the following conditions apply: 

• If there are concerns about maintaining fertility

• If noticeable or bothersome testicular atrophy occurs

• If other hormone imbalance is detected

• If younger patient should maintain natural testicular function

• If a male with moderate testosterone wants to maintain baseline function and who may benefit from the addition of extra testosterone

Side Effects of Taking HCG While on TRT?

In some cases, HCG therapy may cause elevated estrogen levels due to increased  aromatization. This can initially lead to some water retention. This phenomenon tends to self-regulate after 3-6+ months of therapy. And, while estrogen blockers can be used, it is not necessarily recommended due to these changes being mostly transient. 

Generally, HCG and TRT treatments can reduce anxiety and bolster mood, self-assurance, and alleviate anhedonia (depressive-like symptoms). 

Some patients have injection site reactions. In the vast majority of cases, these may cause minor pain, redness, or sometimes swelling, but are typically mild. Typically, injection site reactions reduce over time as the body becomes more accustomed to the treatment. Patients should stay in contact with doctors and inform them in the case of any significant adverse events so they can take the proper course of action. 

HCG and TRT Treatment at Lucidity Health 

HCG is currently available from Lucidity Health for patients for whom it is indicated.

The first step toward TRT treatment or toward getting on HCG to balance your TRT is to get blood work done. This is a simple and easy process involving just a pin prick that can be done at home and helps us understand balance in your endocrine system. 

Lucidity patients have unlimited consults with a doctor available to them as well, in case they are interested in adding HCG. We have a number  

Irrespective of where you are in your TRT journey, feel free to reach out to us for more information. We’d be glad to help!