Patient-Centered TRT: Unveiling the Debate Between HCG and Gonadorelin

February 23, 2024


Navigating HCG Supply: Challenges and Solutions for TRT Patients at NovaGenix health and wellness.

In the realm of Testosterone Replacement Therapy (TRT), the choice between Human Chorionic Gonadotropin (HCG) and Gonadorelin has become a pivotal consideration for both patients and clinicians alike. While HCG has long been a staple in TRT protocols, recent regulatory changes have prompted a shift towards Gonadorelin in some clinics. However, questions linger regarding efficacy, cost, availability, and patient preference between these two medications. This article discusses into the intricacies of this debate, offering insights into the comparative aspects of HCG and Gonadorelin in TRT and shedding light on the factors influencing the decision-making process for both providers and patients. Well answer common questions like, “Which medication is better?” “Does Gonadorelin work?” “Can I still get hCG?”

1. Can I get HCG prescribed still?

Yes, HCG can still be prescribed for patients if it is their preference, despite many clinics generally prescribing Gonadorelin. hCG is still legal, available and quite effective. NovaGenix recognizes and respects the patient's choice in medication and strongly advises patients as to which medication is best suited for their therapeutic needs. We confidently recommend hCG over Gonadorelin for its superior benefits and overall patient satisfaction.

2. What is the cost difference between Gonadorelin and HCG?

Patients on TRT typically spend $30-50 per month for a therapeutic dose of Gonadorelin, while a therapeutic dose of HCG can cost $70-100 per month. It is important to note that the price and supply of HCG are not under the control of the prescribing clinic, which can lead to temporary unavailability or price increases. Fortunately for our patients we have pharmacy partners that are able to assist us and have been able to meet patient demands.

3. What is the risk of running out of medication and experiencing changes in hormone levels with hCG or Gonadorelin?

Currently here is no risk of running out of hCG. Our focus is making sure that patients don’t run out of medications while on testosterone replacement placement therapy (TRT). In the future, the FDA can always make regulatory and legal changes to medication classification and with pharmacies ability to manufacture and dispense medications, but for now we are confident in the supply of therapeutic options available for our patients. There seems to be no shortage of Gonadorelin either, however more patients reach out to us looking to switch back over to hCG after trying gonadorelin, as they feel the effects from hCG are way more noticeable.

4. Is it easy to find a pharmacy that can fill Gonadorelin prescriptions?

Yes, it is extremely easy to find a pharmacy that can fill Gonadorelin prescriptions for patients. They do not have to spend any time or energy in getting their prescriptions filled, as it is conveniently delivered to their doorstep with their other TRT medications.

5. Is it easy to find a pharmacy that can fill hCG prescriptions?

No. unfortunately after the FDA made regulatory changes which now limits the number of pharmacies that can make hCG. There are only 81 503b-compounding pharmacies that are approved by the FDA to produce hCG and FSH, and only 5 of them actually manufacture the medication. This has increased the demand and caused a massive decrease in supply. Fortunately NovaGenix works with pharmacies able to dispense hCG to patients.

6. How does Gonadorelin compare to HCG in terms of potential adverse effects?

Gonadorelin has slightly less potential for adverse effects compared to HCG. HCG can cause the testicles to produce more estrogen directly because it helps produce more testosterone, whereas Gonadorelin does not have this effect. Many patients who have taken both medications have reported better positive effects with hCG in regard to symptom resolution making it our top choice.

7. What are the physical symptoms associated with testicular shrinkage?

Testicular shrinkage can result in smaller testicles, a less full scrotum, and reduced ejaculate. These symptoms can make men feel less masculine and potent. Some men report an aching sensation in their testicles. Our experience is that hCG works better for reversing these symptoms in men who are on TRT.

8. Why do some doctors generally prescribe Gonadorelin instead of HCG?

Some clinics and doctors will prescribe Gonadorelin instead of HCG primarily because they cannot obtain hCG due to the limited supply and high demand. The ability of hCG to maintain fertility and reverse testicular atrophy is far superior as compared to other choices like gonadorelin. Fortunately for our patients, NovaGenix is a clinic that can still prescribe hCG.

9. Which medication do patients prefer?

Universally, we have found that our patients that have tried gonadorelin have not felt the desired effects. Clinical studies that have shown benefits of gonadorelin had been seen when patients were taking doses multiple times a day, and used a pump inserted into their skin to deliver the medication. In the study, patients were administered 10 μg every 90 min subcutaneously using a Hypophyseal Hormonal Infusion Pump. This is not useful for patients on TRT and the efficacy of hCG was may for evident with only a twice weekly subcutaneous injection. hCG for men on TRT is by far the winner.

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Blood Work Request Form

This subsequent lab panel is necessary for males undergoing Testosterone Replacement Therapy (TRT) through NovaGenix Health and Wellness. It allows physicians to assess the patient's response to prescribed medications, covering sex hormone levels, thyroid function, adrenal health, hematocrit, and liver and kidney function. The panel includes tests such as:

  • Complete Blood Count
  • Comprehensive Metabolic Panel
  • Testosterone (Free and Total)
  • Estradiol Sensitive
  • Thyroid Stimulating Hormone
  • Prostate Specific Antigen

Each test serves a specific purpose in monitoring overall health and treatment effectiveness. When required, Dr Mackey may require LH and FSH (Luteinizing hormone, follicle stimulating hormone) SHBG (Sex hormone binding globulin) or any other tests which may be important for your health and optimizing your hormones.

The Comprehensive Hormone and Wellness Panel for Women offers a foundational assessment of sex hormones, thyroid function, adrenal health, metabolic activity, and overall well-being. This panel serves as a diagnostic tool for identifying testosterone and estrogen deficiencies, assessing health risks, and detecting potential thyroid issues before considering hormone replacement therapy. Additionally, it includes insights into hematocrit (red blood cell volume), as well as liver and kidney function. The panel encompasses various tests such as:

  • Complete Blood Count (CBC)
  • Complete Metabolic Panel
  • Testosterone (free and total)
  • Estradiol
  • Thyroid Stimulating Hormone (TSH)
  • Progesterone

When indicated, Dr. Mackey may require additional tests such as Follicle Stimulating Hormone (FSH), and IGF-1 and Cortisol.

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