You also PM’d:
“”“I started working out in January 25, within 3 months I was down 57 lbs…Im down another 10 six months out. My levels are so low im worried there is no chance at children.”""
When did this start?
Any thoughts on timing of T vs weight loss?
Timing of T loss vs any blows to the head?
Is your diet extreme fat free?
What are your cholesterol numbers?
Do you ingest EFAs - fish oil?
Any stimulants? -ephedra or similar
What medicines, OTC and otherwise? PM that if you would rather.
Clomid should not be used long term as TRT is forever. A clomid trial would be of diagnostic value… Do it. If clomid increases HL & FSH, your pituitary and hypothalamus are HPTA functional. If not, you should have your head scoped for problems with the pituitary. If LH and FSH increase and T as well. You have pituitary insufficiency. If LH & FSH increase and T does not, you have testicular failure.
In any case, TRT would work and hCG injections should maintain your testes. If you are concerned about fertility with low hormone levels, have a semen sample examined for quantity and quality of sperm.
How have your testes shrunk now and do the hang low or more pulled up?
TT is very low. That tells you about HPTA output but does not tell you anything about free/bio T. With your prior weight, you may have had a lot of T–E aromatization. Hi T reduces SHBG, low T will increase SHBG. You want higher range albumin to maintain higher bio T. Check that.
E2=29 may be in range, but with your low T, you are very much estrogen dominant. That can mess up mind and body. Once in this state, HPTA problems may be locked in. Could meds have pushed you to this?
You may have syndrome-X aka metabolic disorder: fat, low T, elevated E, endothelial dysfunction, insulin resistance, increased mortality from all causes. Please post serum glucose lab results. metabolic disorder creates a hormone trap that locks one into that state.
Your TRT/HRT should also include 250iu hCG self injected EOD and Arimidex/anastrozole to get E2 into the lower 20’s. With your E as high as it is now, transdermal T may be bad for you. Injections [self] would work well. You need to inject at least twice a week to avoid T spikes that increase E and SHBG. Some supplemental compounded T cream on your scrotum will increase your DHT if needed. But see what your DHT is after 2-3 months on injections. Transdermal T typically increased DHT quite nicely. You sex organs need DHT for maintenance.
If clomid works, you could then add hCG and anastrozole then later taper off of clomid, all in an effort of trying to get back to normal. That may not be enough to get your T back into the upper quartile. We have seen some 19 and 20 old guys with severe HPTA failure and some were lean. These things happen.