Now we do not have any of the expected possible/typical causes. So the hypothalamus and pituitary are not in the game. LH moves a lot during the day, so any given lab sample is not very useful. We really need FSH as it is steadier and a better indicator.
You can try these: - aka HPTA restart
- (A) hCG 250iu SC EOD, see if T improves. If not, testes are not working, stop and go to TRT.
- (B) Nolvadex 25mg ED, see if T, LH and FSH improve, if not, stop and go to TRT, else, keep using, add 0.5mg/week anastrozole in divided doses and keep on, testes need to improve mass and function. Then you can later on, taper off of the Nolvadex and see if things will work. Stay on the Nolvadex to prevent E2 rebound from causing shutdown.
Never use hCG and a SERM [Nolvadex, Clomid] at the same time. Never use high hCG doses.
If (A) works, your TRT could be hCG mono therapy if T levels are good enough, else get T injections or transdermals.
Note if (B) results are good but not good enough, you results on a restart can be expected to be inadequate.