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Author Topic: Dr. Shippen's HCG Challenge  (Read 810 times)

davie12

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Dr. Shippen's HCG Challenge
« on: September 11, 2013, 07:26:22 am »
Actually, Shippen philosophically believes in doing everything he can to get your system producing its own hormones so he pretty much uses TRT if everything else fails.

Wow.  Very interesting...

If you read the exact text of his HCG challenge, he categorizes patients as low, mid-level or high-level responders and identifies a treatment regimen for each. So basically, he is saying, for example, if there is no testicle response to HCG, use exogenous testosterone, mid-level use HCG+T and high responders, only HCG. There isn't a perfect correlation sometimes. For example, if someone goes over 500iu/injection and can get a decent T level, he allows for titrating dosages accordingly. There can be other things going on in one's endocrine system and responses to HCG can improve over time. However, I bring all this up as the HCG challenge is more than just a test for primary vs. secondary...he is trying to assess how much a patient's own system can produce its own hormones.
Recovering from adrenal fatigue/endocrine disruption after antibiotic regimen
HCG 700/3x/week, Anastrazole 0.1mg minitroche/2x/week
6 May 2013: TT 550, Free T 15, SHBG 34, E2 74
Currently normalizing/optimizing adrenal hormones cortisol, DHEA, DHEA-S, Pregnenolone through exercise & supplements

PeakT

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Re: Dr. Shippen's HCG Challenge
« Reply #1 on: September 11, 2013, 08:32:35 am »

If you read the exact text of his HCG challenge, he categorizes patients as low, mid-level or high-level responders and identifies a treatment regimen for each. So basically, he is saying, for example, if there is no testicle response to HCG, use exogenous testosterone, mid-level use HCG+T and high responders, only HCG. There isn't a perfect correlation sometimes. For example, if someone goes over 500iu/injection and can get a decent T level, he allows for titrating dosages accordingly. There can be other things going on in one's endocrine system and responses to HCG can improve over time. However, I bring all this up as the HCG challenge is more than just a test for primary vs. secondary...he is trying to assess how much a patient's own system can produce its own hormones.

Two questions for you:

1.  I thought he only allowed for 250 IU 3X/week?  Are you saying that he will do 500 IU or more 3X/week for monotherapy?

2.  I searched and cannot find a paper actually written by him on the "HCG Challenge" or "HCG Stimulation Test"?  Have you seen this anywhere?
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements. Yes, low T and E.D. are usually medical conditions.
My Health History: http://www.peaktestosterone.com/My_Health_Story.aspx.
And check out my new Peak Testosterone Program on the right side of my home page: http://www.peaktestosterone.com.

davie12

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Re: Dr. Shippen's HCG Challenge
« Reply #2 on: September 11, 2013, 09:30:47 am »

If you read the exact text of his HCG challenge, he categorizes patients as low, mid-level or high-level responders and identifies a treatment regimen for each. So basically, he is saying, for example, if there is no testicle response to HCG, use exogenous testosterone, mid-level use HCG+T and high responders, only HCG. There isn't a perfect correlation sometimes. For example, if someone goes over 500iu/injection and can get a decent T level, he allows for titrating dosages accordingly. There can be other things going on in one's endocrine system and responses to HCG can improve over time. However, I bring all this up as the HCG challenge is more than just a test for primary vs. secondary...he is trying to assess how much a patient's own system can produce its own hormones.

Two questions for you:

1.  I thought he only allowed for 250 IU 3X/week?  Are you saying that he will do 500 IU or more 3X/week for monotherapy?

2.  I searched and cannot find a paper actually written by him on the "HCG Challenge" or "HCG Stimulation Test"?  Have you seen this anywhere?

Answers:
1) Actually, the starting dose is 500iu 3x/wk. In fact, he wrote that on a prescription slip when he corresponded with me initially. The text of his HCG challenge then states basically that mid-level responders can go up in dosage accordingly. He is reasonable with this and conservative, thus, the idea is to go up just enough to get to a good testosterone level. Of course, if someone responded well to such a low dose such as 250, that could be a workable dose. However, if someone responded to such a low dose, that would intuitively tell me they've got severe pituitary dysfunction (ie. low LH).

2) I'll have to dig this up for you later. It is in several places on the web. I'll get back to you on this.

EDIT: See below.

Chorionic Gonadotrophin Stimulation Test (males < 75 years old)*

 Chorionic Gonadotrophin is presently available through most pharmacies
 or distributors as Profasi, Pregnyl or generic Chorionic Gonadotrophin
 10,000 units per 10 cc vial. Various stimulation tests have been
 described, from high dose, short course testing to more normal
 physiologic doses over a longer time period. I have found that a typical
 treatment course for three weeks is best for determining those
 individuals who will respond well to this type of treatment. It is
 administered by injection 500 units (0.5 cc) SQ, Monday through Friday
 for three weeks. Teach patient to self administer with 50 Unit Insulin
 Syringes with 30 gauge needles in anterior thigh, seated with both hands
 free to perform the injection. Measure: Testosterone, total and free,
 plus E2 before starting CG and on the third Saturday AM after 3 weeks of
 stimulation (salivary testing may be more accurate for adjusting doses).
 Studies have shown that SQ is equal in efficacy to IM administration.

 Results:

 1. <20% rise suggests poor testicular reserve of leydig cell function
 (primary hypo-gonadism or eu-gonadotrophic hypo-gonadism indicating
 combined central and peripheral factors).

 2. 20-50% increase indicates adequate reserve but slightly depressed
 response, mostly central inhibition but possibly decreased testicular response as well.
 3. > 50% increase suggests primarily centrally mediated depression of
 testicular function.

 Options for treatment vary both with the response to CG and patient
 determined choices.

 1. If there is an inadequate response (< 20%), then replacement with
 testosterone will be indicated.

 2. The area in between 20-50% will usually require CG boosting for a
 period of time, plus natural boosting or "partial" replacement options.
 I believe that full replacement with exogenous testosterone is always
 the last option in borderline cases since improvement over time may
 frequently occur as leydig cell regeneration may actually happen. Much
 of this is age dependent. Up to age 60, boosting is almost always
 successful. 60-75 is variable, but will usually be clear by the results
 of the stimulation test. Also, disease related depression of
 testosterone output might be reversible with adequate treatment of the
 underlying process (depression, AMI, obesity, alcohol, deficiency, etc.)
 This positive effect will not occur if suppressive therapy is instituted
 in the form of full replacement.
 3. If there is an adequate response, >50% rise in testosterone, there is
 very good leydig cell reserve. Natural boosting or CG therapy will
 probably be successful in restoring full testosterone output without
 replacement, a better option over the long term and a more natural
 restoration of biologic fluctuations for optimal response.

 4. Chorionic Gonadotrophin can be self-administered and adjusted
 according to response. In younger, high output responders (T >
 1100ng/dl), CG can be given every third or fourth day at bedtime or in
 the AM. This also minimizes estrogen conversion. In lower level
 responders(600-800ng/dl), or those with a higher E2 output associated
 with full dose CG, 300-500 units can be given Mon-Wed-Fri. At times,
 sluggish responders may require a higher dose to achieve full
 Testosterone response. In these cases, the diluent is lowered to 7.5cc
 or even to 5 cc, which increases the CG concentration 1 - 2 X. This
 can be administered in variable doses 0.3 - 0.5cc given every 3rd day.
 Check salivary levels on the day of the next injection, but before the
 next injection to determine effectiveness and to adjust the dose
 accordingly. Keep in mind that later as leydig cell restoration occurs,
 a reduction in dose or frequency of administration may be later needed.

 5. Monitor both Testosterone and E2 levels to assess response to
 treatment after 2 - 3 weeks after change in dose of CG as well as
 periodic intervals during chronic administration. Sublingual testing is
 very easy and cost effective. It will also better reflect the true free
 levels of both estrogens and testosterone. (Pharmasan Labs 888-342-7272
 is very good)

 6. Adjustment of dosage is a result of symptomatic response and hormone
 level boosting. It is based on clinical judgement as much as actual
 hormone levels. Remember that "Normal" ranges are for populations, not
 individuals!

 7. Except for reports of antibodies developing against CG (I have not
 seen this), there are no adverse effects of chronic CG administration.
 An additional benefit is the boosting of Growth Hormone output which has
 also been reported, either as a direct effect of CG or as an effect of
 increased levels of testosterone.

 *Protocol adapted from "The Testosterone Syndrome" by Eugene Shippen, M.
 D. (M Evans and Co, NY 1998).
« Last Edit: September 11, 2013, 05:19:19 pm by davie12 »
Recovering from adrenal fatigue/endocrine disruption after antibiotic regimen
HCG 700/3x/week, Anastrazole 0.1mg minitroche/2x/week
6 May 2013: TT 550, Free T 15, SHBG 34, E2 74
Currently normalizing/optimizing adrenal hormones cortisol, DHEA, DHEA-S, Pregnenolone through exercise & supplements

PeakT

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Re: Dr. Shippen's HCG Challenge
« Reply #3 on: September 11, 2013, 05:51:10 pm »
So Leydig cell regeneration can occur in some cases?  That is interesting!

Also, it's int'g that he uses salivary testing.

And, yes, now I see what you were talking about.
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements. Yes, low T and E.D. are usually medical conditions.
My Health History: http://www.peaktestosterone.com/My_Health_Story.aspx.
And check out my new Peak Testosterone Program on the right side of my home page: http://www.peaktestosterone.com.

PeakT

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Re: Dr. Shippen's HCG Challenge
« Reply #4 on: September 11, 2013, 05:54:20 pm »
By the way, I love how he is doc that run his clinic with both his brain AND his heart.  He protocols make sense and it sounds like he really cares about the patients, takes time to fully diagnose them and want to do what is best for them in the long haul even if it's not the cheapest or fastest option...
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements. Yes, low T and E.D. are usually medical conditions.
My Health History: http://www.peaktestosterone.com/My_Health_Story.aspx.
And check out my new Peak Testosterone Program on the right side of my home page: http://www.peaktestosterone.com.

davie12

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Re: Dr. Shippen's HCG Challenge
« Reply #5 on: September 11, 2013, 08:26:00 pm »
So Leydig cell regeneration can occur in some cases?  That is interesting!

Also, it's int'g that he uses salivary testing.

And, yes, now I see what you were talking about.

Yes, I've seen the leydig cell regeneration also in a study. I believe it was mentioned by one of your posters a while back. It was a rat study, but nevertheless, it seems to be acknowledged quite a bit.
Recovering from adrenal fatigue/endocrine disruption after antibiotic regimen
HCG 700/3x/week, Anastrazole 0.1mg minitroche/2x/week
6 May 2013: TT 550, Free T 15, SHBG 34, E2 74
Currently normalizing/optimizing adrenal hormones cortisol, DHEA, DHEA-S, Pregnenolone through exercise & supplements

PeakT

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Re: Dr. Shippen's HCG Challenge
« Reply #6 on: September 11, 2013, 09:04:31 pm »
So Leydig cell regeneration can occur in some cases?  That is interesting!

Also, it's int'g that he uses salivary testing.

And, yes, now I see what you were talking about.

Yes, I've seen the leydig cell regeneration also in a study. I believe it was mentioned by one of your posters a while back. It was a rat study, but nevertheless, it seems to be acknowledged quite a bit.

Ahem.  # # clearing throat # #

Actually, the poster was me:

http://peaktestosterone.com/forum/index.php?topic=380.msg3403#msg3403
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements. Yes, low T and E.D. are usually medical conditions.
My Health History: http://www.peaktestosterone.com/My_Health_Story.aspx.
And check out my new Peak Testosterone Program on the right side of my home page: http://www.peaktestosterone.com.

kregger

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Re: Dr. Shippen's HCG Challenge
« Reply #7 on: January 08, 2014, 06:43:24 pm »
Anyone have a link to Shippen's protocol?  I have a dr's appt coming up and I'd like to hand the doc a printout in case he's on the fence about HCG.  When I mentioned it my last visit, he didn't seem too familiar with it and just said "maybe we'll give it a try next time."
1st Labs: Total Test = 558, Free Test = 44.8, Bioavailable Test = 100.0, SHBG = 59
3rd Labs: Total Test = 489, Free Test = 39.5, Bioavailable Test = 79.4, SHBG = 59
5th Labs: Total Test = 949, Free Test = 29, Estradial = 36 pg/mL
6th Labs: Total Test = 936, Free Test = 24.9, SHBG = 35.0 (range 11-80), Estradial = 39
BEGAN IM INJECTIONS OF 100 MG/WK CYPIONATE ON 08/2013
BEGAN SUB-Q INJECTIONS OF 100 MG/WK CYPIONATE ON 10/2013

Sam

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Re: Dr. Shippen's HCG Challenge
« Reply #8 on: January 08, 2014, 07:10:49 pm »
Does he have a website?
7/6/12   - 154/4.5; PSA 1.7
1/31/13  - 292/5.4; Cort 5.0; SHBG 17.8
3/25/13  - 329/7.4; Cort 11.8, E2 23; PSA <0.5
7/5/13 - Started T Cyp - 100mg biweekly IM
7/19/13 Trough - 260/7.8; SHBG 15.4; E2 17
7/26/13 Midpt - 228/5.4 - moved to 100mg/wk
8/29/13 - Trough - 219/39.5; Cort 11.3
8/30/13 - Peak - >1500/>52; E2 101; PSA 1.8
9/5/13 - Trough - E2 12 - Moved to 100mg/ml,  1ml weekly
- Moved to subQ 30mg EOD solved all my issues except evening fatigue.  T levels consistently 500-600 E2 20-40
12/6/13 - Switched to Clomid 50mg 2x/wk.  finally settled in on 12.5mg EOD
1/15/14 - Stopped Clomid

PeakT

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Re: Dr. Shippen's HCG Challenge
« Reply #9 on: January 08, 2014, 08:17:42 pm »
Does he have a website?

No and he's hard to get into from what I've heard.  I'll send you a PM with some info if I can.  One sec...
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements. Yes, low T and E.D. are usually medical conditions.
My Health History: http://www.peaktestosterone.com/My_Health_Story.aspx.
And check out my new Peak Testosterone Program on the right side of my home page: http://www.peaktestosterone.com.

kregger

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Re: Dr. Shippen's HCG Challenge
« Reply #10 on: January 09, 2014, 06:46:48 am »
Any luck finding Shippen's protocol?  If not, would you recommend another HCG link to persuade a doctor to give it a try?
1st Labs: Total Test = 558, Free Test = 44.8, Bioavailable Test = 100.0, SHBG = 59
3rd Labs: Total Test = 489, Free Test = 39.5, Bioavailable Test = 79.4, SHBG = 59
5th Labs: Total Test = 949, Free Test = 29, Estradial = 36 pg/mL
6th Labs: Total Test = 936, Free Test = 24.9, SHBG = 35.0 (range 11-80), Estradial = 39
BEGAN IM INJECTIONS OF 100 MG/WK CYPIONATE ON 08/2013
BEGAN SUB-Q INJECTIONS OF 100 MG/WK CYPIONATE ON 10/2013

PeakT

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Re: Dr. Shippen's HCG Challenge
« Reply #11 on: January 09, 2014, 07:56:05 am »
Any luck finding Shippen's protocol?  If not, would you recommend another HCG link to persuade a doctor to give it a try?

Dr. Crisler does HCG Monotherapy I am pretty sure.
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements. Yes, low T and E.D. are usually medical conditions.
My Health History: http://www.peaktestosterone.com/My_Health_Story.aspx.
And check out my new Peak Testosterone Program on the right side of my home page: http://www.peaktestosterone.com.

kregger

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Re: Dr. Shippen's HCG Challenge
« Reply #12 on: January 09, 2014, 09:11:25 am »
1st Labs: Total Test = 558, Free Test = 44.8, Bioavailable Test = 100.0, SHBG = 59
3rd Labs: Total Test = 489, Free Test = 39.5, Bioavailable Test = 79.4, SHBG = 59
5th Labs: Total Test = 949, Free Test = 29, Estradial = 36 pg/mL
6th Labs: Total Test = 936, Free Test = 24.9, SHBG = 35.0 (range 11-80), Estradial = 39
BEGAN IM INJECTIONS OF 100 MG/WK CYPIONATE ON 08/2013
BEGAN SUB-Q INJECTIONS OF 100 MG/WK CYPIONATE ON 10/2013

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Re: Dr. Shippen's HCG Challenge
« Reply #12 on: January 09, 2014, 09:11:25 am »