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Testosterone: Support, don’t Suppress |
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Written by By Dan Gwartney, MD
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Tuesday, 03 February 2009 |
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Page 6 of 8
There are some points that should be considered by those interested in using hCG for enhancing testosterone production. First, it typically is packaged as a dry powder that needs to be mixed with sterile water, though there are pre-mixed options available. Second, hCG needs to be protected from heat and not exposed to direct sunlight. This is especially important after the powder has been dissolved, as proteins are not stable and become biologically inactive if exposed to heat or left in solution for a long period. Most users follow the recommendation to refrigerate hCG all the time, just like growth hormone. Many users substitute bacteriostatic water for the packaged sterile water to prolong storage. Third, hCG needs to be injected. As it is equally effective injected into the muscle, a vein or under the skin, most people take the path of least resistance and inject the drug subcutaneously; insulin syringes are often used.19 Fourth, the drug does not last in the system long. It is much more stable than LH, but as it rapidly enters the bloodstream, hCG needs to be injected daily or every other day. Protein hormones such as hCG, growth hormone and insulin can not be esterified like steroids to allow weekly injections, making the protein-based drugs less convenient. Fifth, hCG can max out natural testosterone production, but does not offer any testosterone increase beyond that point. The maximum response has not been clearly defined but it would appear that hCG is able to double testosterone production. It is possible that greater increases may be possible, but certainly not the ultra-high levels seen with anabolic steroid use. Sixth, as testosterone increases; so too does estrogen. The body produces and handles testosterone exactly as it would naturally, just more so. The positive to this is that the T-E ratio (testosterone to epitestosterone) is “normal” which would allow an athlete to use this drug to increase testosterone concentration without failing a drug test based upon T-E ratio.15 This may be a moot point in many cases as hCG is easily detected as well.24 Gynecomastia is often reported during hCG use for post-cycle recovery because of the associated estrogen increase.25 Lastly, hCG is dependent upon testicular function. Older men may not receive as much benefit from hCG as middle-aged and young adult men would.26
Another category of drug used to increase testosterone is anti-estrogens. This awkward term refers to drugs that block the estrogen receptor or inhibit estrogen production by blocking the aromatase enzyme that converts androgens to estrogens. Classically, bodybuilders use a drug called tamoxifen (Nolvadex) to block the actions of estrogens at their receptor.27 Nolvadex is not a pure estrogen blocker, and some breakthrough is often experienced with gynecomastia and water retention being the main complaints. Tamoxifen was developed for use in breast cancer patients to reduce the hormonally stimulated growth of tumors in the breast. A similar drug, Clomiphene (Clomid) is used in fertility clinics to enhance a woman’s ability to stimulate the ovaries to produce eggs by increasing the signal from the hypothalamus and pituitary. Aromatase inhibitors (Arimidex, Femara) are becoming popular options for both breast cancer treatment and infertility as they block the formation of estrogen, rather than attempting to block its signal.28
Focusing on estrogen seems antithetical (opposite thinking) when one is attempting to increase testosterone. To understand the role estrogen plays in testosterone production, it is important to understand that testosterone is a pro-hormone, in addition to being a hormone.29 Testosterone can act directly with androgen receptors (making it a hormone) or be further metabolized into estradiol or dihydrotestosterone (DHT) which then act with steroid receptors, typifying testosterone as a pro-hormone. Estrogen interacts with a different receptor (the estrogen receptor) than testosterone or DHT (the androgen receptor). The signal from estrogen is often stronger than the signal provided by testosterone, explaining why estrogenic side effects are so common even when the testosterone concentration is so much greater in the blood. Further, many tissues (breast, fat, etc) contain high levels of the aromatase enzyme, increasing the potential for testosterone to be converted to estrogen and act directly on the site.
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Research and Review 
