Hi All,
I will try keep this as short as possible.
As long as I can remember I have been lethargic and battled to get up in the morning. I also suffered from anxiety, moodiness and sleep issues. I have tried antidepressants etc with little effect. I normally use caffeine pills etc to get me going. I am 42 now.
So in late 2011 my GP ran tests and said I had low test (TT 223) and low vitamin D. She gave me the test cream but this didn’t work. She then gave me a Nebido test shot (1000mg) and I felt great. Problem was after that my nuts shrank and I had pain in one.
She then recommended an endocrinologist who ran tests and identified that I had Tertiary hypogonadism (Hypothalamus). He put me on clomid and after a while my TT was at 769. He then had to add Femara as an AI to reduce my E2. After a few months on clomid he said I should stop and that we had ‘rebooted’ my system. Fast forward almost 2 years and my low test symptoms are as bad as ever – my TT is now 323.
I want to start long term HRT and am going to see a doc on Friday. I have played with some options below – any advice or correctiions would be much appreciated.
Tiffer

Bloods:
15 November 2011 (1st Test)
Total Testosterone 224.78 ng/dl
Free Testosterone 64.84 pg/ml
SHBG 13.70 nmol/L
DHEA-S 274.54 ug/dl
S-Cortisol 9.42 ug/dl
S-PSA 0.79 ng/mL

10 September 2012 (After Clomid)
Total Testosterone 769.45 ng/dl
Free Testosterone 242.36 pg/ml
Estradiol (E2) 54.22 pg/ml
SHBG 15.40 nmol/L
DHEA-S 376.38 ug/dl
LH 8.90 mIU/mL
FSH 14.30 mIU/mL

10 March 2014
Total Testosterone 322.77 ng/dl
Free Testosterone 91.35 pg/ml
Estradiol (E2) 20.16 pg/ml
SHBG 15.70 nmol/L
S-Prolactin 5.10 ng/mL
DHEA-S 322.51 ug/dl
Vitamin D 25 41.60 ng/mL
S-TSH 1.03 uIU/ml
S-Cortisol 5.72 ug/dl
Insulin 9.20 uIU/ml

The clomid definitely worked, but these are the options I am considering:

Clomid 25mg every 2 days
Arimidex (Anastrozole) 0.25mg every 2 days

OR

50mg Testosterone enanthate /cypionate every third day
0.25mg Arimidex every third day
500IU HCG every third day

And on last thing - I found these target levels - are these reasonable?

Total Testosterone 800-1000 ng/dl
Free Testosterone 250-300 pg/ml
Estradiol (E2) 20-30 pg/ml
SHBG 10-30 nmol/l
DHT 60-70 ng/dl
Prolactin 2-3 ng/ml
DHEA-S ~300 ug/dl
Vitamin D >30ng/ml