Jeremiah Velasquez: Welcome back guys to another episode of Hormones Happen. I'm your host Jeremiah, also known as the Optimized NP on TikTok. And let me just kind of lay something out, ⁓ started TRT because you wanted to be a high performance individual. ⁓ want to optimize your life, all that cool shit we talk about. ⁓ now ⁓ balls are half the size, your limbedo is ⁓ your semen volumes are almost gone, ⁓ you just feel off. What the hell? Did we lie to you? Well, this is not a common scenario. Okay, I want that to be known, but it does happen. And so can we do when someone's on testosterone? ⁓ optimizing everything like we want right? We're trying to, but you're still just not getting that main benefit. Well, ⁓ enter human chorionic gonadotropin. ⁓ Now got some personal opinions I'd like to talk about. But I'm going to save those to the end because I want to focus on the science. I want to focus on the literature. I want to focus on ⁓ meat and potatoes of this topic. And so in order to really understand how HCG works, how it affects us, we have to talk about the three main areas of testosterone production. Now, our first one is the hypothalamic pituitary gonadal axis, the HPG axis. This includes the hypothalamus in the brain, anterior pituitary gland, which is a gland underneath the brain, and of course the gonads. Now, way this works is the hypothalamus releases ⁓ gonadotropin-releasing ⁓ to anterior pituitary gland, which then sends ⁓ LH FSH, ⁓ luteinizing and follicle stimulating hormone ⁓ to gonads, which interact with what are called the lating cells ⁓ to testosterone. Now, There is a very complicated pattern. It's called steroidogenesis. This is a pathway that makes testosterone. And believe it or not, guys, it all starts with cholesterol. I know, crazy, everyone tells you to avoid it, but I'm telling you to go after it. So with the steroidogenesis pathway, we have cholesterol. Underneath it, we have pregnenolone, which we call the mother hormone. And underneath that, we have several different downstream metabolites like progesterone, 17 alpha hydroxyprogesterone, DHEA, androsteadone, finally testosterone. We finally get to testosterone. I'm sorry I had to talk to you about all that, but this is so incredibly important because this is going to explain ⁓ HCG works. ⁓ with HPG axis, this is 95 % of our testosterone production. ⁓ This the powerhouse of testosterone production. And what's important to realize about this ⁓ is intratesticular testosterone. is influenced by this. our intratesticular testosterone is 50 100 times higher than what's in our bloodstream. ⁓ And that's because we need high levels of progesterone. ⁓ We also estradiol to help with sperm viability, AKA fertility. Now, what's the second pathway? Well, the hypothalamic-pituitary-adrenal axis. Now the adrenal are two glands that sit on top of our kidneys. And we're also making hormones here, but mostly precursors like DHEA, DHEAS, and androstedione. We're really making about less than 5 % of our overall testosterone production in the adrenal glands, but we're still making it. And so it goes through the same steroidogenesis pathway, same thing as we talked about with the gonads. Now, finally, peripheral conversion. To really understand this, we have to talk about the difference between an intracrine hormone and an endocrine hormone. So an endocrine hormone is a hormone that's secreted by a gland, goes through the bloodstream, and acts on different receptors. an intracrine hormone is made at the level of the tissue. It's converted locally at the site of the tissue. And then whatever leaks out into the blood doesn't have any effect. A great example would be estradiol. gets converted from testosterone via an enzyme called aromatase into estradiol, acts on the tissue, and then whatever you see in the blood work is just spill over. It's not really metabolically active at all. Now testosterone's both, ⁓ secreted by a gland, goes through the bloodstream, acts on antigen receptors. It also gets converted from DHEA and angiostidione at the level of the tissue, like tissues in the skin, fat Prostate tissue and so that's another way that we're making testosterone. So there's three ways that we're making testosterone and so how does affect our testosterone production now when you're taking testosterone via ⁓ pill cream. ⁓ call this exogenous. ⁓ coming from outside the body ⁓ your brain's smart, but it's not that smart It doesn't know, wow, Jeremiah is injecting testosterone into his shoulder. Your brain thinks, making too much testosterone. And all your brain can do is stop production. It can't ⁓ it or excrete it. All it can do is stop production. So ⁓ ⁓ cease produce. ⁓ And that results in ⁓ is your production ⁓ shutting Now what's important to know, and not a lot of guys know this, is that you don't have to be on testosterone forever. We're not permanently suppressing our natural testosterone production. want you to think of your ⁓ as like a thermostat in the background, and you have a baseline here. ⁓ you're on exogenous testosterone, your levels could be way up here, your brain says, that's too high, stops making its natural production. Now let's say you get off for whatever reason, your levels will fall. They will fall below. when you start it, your brain's gonna say, my God, we're at a testosterone of 50, we need to make some testosterone. And it'll bring it back up to this baseline that we don't know what that is, I'm sure it changes and there's a lot of variables that affect what it is, ⁓ it will bring it back up. ⁓ so it's a thermostat. ⁓ when you're on exogenous testosterone, the thermostat's off, okay? We're not making our natural testosterone production. And that is really where HCG shines. what ⁓ HCG? So human chorionic gonadotropin. It's made predominantly in the placenta ⁓ specialized cells ⁓ ⁓ Okay, and this is during pregnancy. Now as men, we don't make this guys. We do not make ⁓ However, it can be detectable in pathological conditions. like testicular germ cell tumors or even some non-testicular tumors, but we don't make it. We shouldn't be making any of this. so ⁓ we talk about ⁓ ways improve your testosterone, this is not it. We are going to naturally stimulate testosterone production through our endogenous system, ⁓ but is nothing natural about taking HCG. Nothing natural about it at all. It's probably the most unnatural thing you can do. Testosterone is actually more natural. But what does it do and how does it differ from testosterone? Because that's important. Because remember, you're on testosterone, but you feel like shit right now. And so now me and you are trying to figure out, is HCG a good option for you? So HCG to us acts like luteinizing hormone. Now remember, our brain's not making it anymore because our brain's freaking out and saying, holy shit, your testosterone's 1,500. I'm never making this. And now we're saying, yeah, you will. yeah, we're gonna make some of this ourself. ⁓ So taking HCG, it acts as luteinizing hormone, ⁓ goes and interacts with those lating cells again. And guess what? ⁓ We that whole complicated pathway we just talked about, steroidogenesis. ⁓ And we this backfilling, okay? ⁓ And the we call it this is because we have our cholesterol here, we have our testosterone here, we're taking testosterone, okay? We feel cool, we feel good, ⁓ but now not feeling so good. this whole pathway that we talked about, you know, our pregnenolone, progesterone, our DHEA, atrosteidone, this is off, okay, nothing. Now we're stimulating it, guess what? We're getting signal again. So we're lighting this pathway up. So we're getting all those precursors in our gonads again, which we weren't before. And that's where that term backfill comes in, because we weren't getting those, they were gone. Now we're getting all those precursors. What does this lead to? Why is that even important? Well, by stimulating your natural testosterone production, intratesticular testosterone comes back, Remember, it has to be very high for sperm health. So we're getting increased sperm production. fullness, guys will say, ⁓ my God, my balls are back. And also indirectly stimulating ⁓ what called sertoli cells, ⁓ which cells stimulated by FSH. They create other hormones like Androgen binding protein and him and a other very important things for fertility. So we're improving Fertility that's huge for a lot of young men But some guys say I do not want any kids never never had them or I have my whole family I don't want to take this stuff. Well, guess what? It's not just for fertility. The fertility is because we're stimulating natural production but mood benefits by backfilling those hormones Remember, we're also getting pregnant alone, progesterone, and all these other neuro steroids. Now, let's take a second to talk about progesterone, because a lot of people hear progesterone, and they think about it being a female hormone. And that's true. It's very important for women. It helps to modulate the uterine lining, prevent endometrial and uterine cancers. for us guys, we make too. ⁓ We it. Now, since our gonads are now turned off, we're not making it in our gonads. We're still making it in the adrenals, okay? That's important to know. We're still making it, but we're not making as much. Is it theoretically fair to say we're deficient now? Well, sure. Do I think you need to test it? No, I don't. One thing I will say about progesterone is that there is research being done that is showing significant benefit for men for depressive mood disorders. anxieties, sleep. This is something we're looking into and I would not be surprised that if shortly down the road this becomes something that we start promoting more. Hey guys, I think you would really benefit from some progesterone in addition to your testosterone. Now I have personally been on progesterone on and off for the last probably year and a half. I take it almost every night now. 200 milligrams oral micronized progesterone, same as we give the women. And I can absolutely tell you there are amazing benefits to it. Better sleep, decreased anxiety. Some guys will report decrease in migraines. But how does it do that? So progesterone outside of the uterine lining benefits breaks down into allopagnolone, which we call colloquially as the valium of the brain because it goes up to the brain guys, GABA-A receptors, which are these feel-good neurotransmitters, these... these these neural hormones that make you feel really good and when it stimulates those guess what you feel really good and I can attest to this absolutely have never slept better if really stressed at the end of the day boom ⁓ it guys it really does help ⁓ and backfilling that whole chain from cholesterol to testosterone we're making progesterone ⁓ and getting that progesterone again to what degree Hard to say, we will talk about this a little bit at the end, it's hard to say. Now, what kind of things can you expect from this? Improved clarity, better stress tolerance, ⁓ reduced Those are some of the mood benefits that you can get from this. It's not just for fertility, guys. Now, how is HCG taken? Well, it's typically taken as a subcutaneous injection, ⁓ meaning tissue, you pinch up some belly fat, it in. roughly two to three times per week. There's a very wide therapeutic window, depending on your goals. Anywhere from just, I just want to feel a little bit better on my testosterone, to, hey, I'm really actively trying to have a family, I need fertility. because of that, your goals depend or determine the dosage. Anywhere from 200 IUs, international units, to ⁓ is range. So as you can see, very, very wide. I will typically put my guys on 500 I use, twice a week. Just inject it same days as you do your testosterone. Keep it simple. No reason to over complicate this. Now, what are my thoughts on HCG? Remember, I said was gonna tell my personal thoughts on this and do I think it's worth investing? Do I think everyone should use it? And what are some caveats? So, I used to think HCG only served a purpose for fertility. I would not really humor using it unless someone was considering family planning and we would use it as an adjunct. At that point, I'd say, yeah, I think HCG is gonna benefit you. Outside of that realm, I would literally use the term, it's a waste of money. That was before I actually started to see the amazing benefit men who were on it. Maybe originally starting for fertility, but then they'd say, I want to stay on this. I feel a thousand percent better. And that might be an exaggeration. Most guys feel fantastic on just testosterone. I think everyone ⁓ needs I think that ⁓ most will benefit from it, ⁓ but what degree? It depends on how sensitive you are to no longer producing those precursor hormones. Now, caveat to this ⁓ you really need to be aware of is how well are your testes working? Because that's really gonna determine how much back feeling essentially we're getting. Because ⁓ you have a primary hypogonadism, which means ⁓ brain is stimulating the testes, ⁓ the testes are not doing anything, they're not producing the hormones like we want them to, you're not gonna get great effect. Because... With a primary hypogonadism, which is typically caused by age, trauma, infection, surgical removal called an orchiectomy, if it's not responding to naturally produced luteinizing hormone, we can give it an LH memetic like HCG. It is not going to stimulate because it's just not working right. Something's wrong with the testes. It's just not doing its job or just part of natural aging. in elderly men, this is something to consider. They may not be getting as good a response. if you've done some blood work prior to getting on testosterone and you've been identified as having this primary hypogonadism, you're probably not going to get a great response. is ⁓ caveat, is it's only going to be as effective as your testes allow it. ⁓ remember, we're not going to get supraphysiological levels with It's only going to be what the testes can produce. ⁓ There's to be a natural limiter on there. Do I think it's beneficial to Try? Sure, absolutely. If you're having any of those issues we talked about at the beginning, absolutely, I definitely think it's something to look into. Because what's the other alternative? Well, I'm gonna keep increasing my dosage of testosterone. I'm gonna keep pushing it and pushing it. And I've seen this, guys, time and time again, and the symptoms just aren't getting better, but now we have acne. Now our erythrocytosis is increasing. Well, maybe it's the precursor hormones we need to look at a little bit closely. Now what about taking pregnant alone or DHEA over the counter orally? Sure, that is also worth a shot. I have not personally seen great effect with that. I've done it myself, just arbitrarily taken. I never weighed it, never measured it, just DHEA, pregnant alone. I can't say that I had a significant benefit from it. Is it a waste? I don't know. But what I can tell you is that from the science that we talked about today, HCG definitely does. something. Is it going to be the something that you need? just depends because like I said at the beginning, ⁓ everyone needs this. That scenario is not common. Most guys get on testosterone ⁓ they feel amazing considering the things that they do in their life to help ⁓ it that way. But some guys, no matter what, optimizing everything they can, they still have those issues. ⁓ for those individuals, I think HCG ⁓ a fantastic ⁓ to use. I hope you guys liked this episode. hope you learned a lot. Ladies, if you're listening, this is also important for you too. thanks for joining us. Most importantly, everyone ⁓ optimized.