TRT in the UK
Following my last consultation with Dr. Stevens, we had a brief talk about HCG and dosage frequency, as my Oestradiol (E2) had increased a considerable amount.
It’s well known that we often see a peak in testosterone within 3 days using HCG and that once the threshold dose is met, the increase in testosterone isn’t as dramatic (Bauman et al., 2017). It’s also known that E2 reaches its serum peak within only 24 hours (Meier et al., 2005). The primary cause of elevated E2 due to HCG is that Intratesticular E2 production (Valladares and Payne., 1979).
Therefore, large bolus doses of HCG will simply just lead to a large increase in intra testicular E2, only worsened by the additional conversion of T -> E2 from endogenous T and external sources. Clearance of E2 takes time.
While SHBG will increase due to increased E2 and androgens, it won’t increase enough to combat the high E2 in some individuals The net result is you’re left with E2 that continues to increase as there is less downregulation of aromatase activity (acute increases will not cause as much of an effect on aromatase expression) concurrent with those HCG induced peaks, which by the way are dose-dependent.
The point I’m getting at is that a more frequent and smaller dose of HCG will lead to more favourable results as we get far smaller peaks, more sustained (chronic) increases, and appropriate E2 metabolism. Therefore, you get less side effects and less of an increase in E2. I hope to soon be added proof to that, but many can attest to this in forums where they are now praising HCG protocols with daily smaller doses and feeling far better for it too.
So, if your E2 is getting too high, first review your protocol before asking or letting the doctor put in an aromatase inhibitor! Frequency and dose matters, guys.