Very Low Free T, Moderate SHBG

Hi,
A little history to start with. At the age of 20 I experimented with one shot of test enanthate 50mg.Yes one single shot. My hormones have never been the same since then. I wasn’t able to recover fully. And I was too scared to deal with it for all these years.I’m 28 rn. (i know i fucked it up like many young people ). And now i want to deal with it before it is too late.
Here are my numbers.
Free testosterone : 40pg/ml
Total testosterone : 618ng/dl
SHBG: 48
FSH: 4.3
Lh: 2.24
Prolactin : 9.57
E2: 30

TSH: 1.4 uiU/ml
FT3: 2.9 pg/ml
FT4: 1.2

I have been noticing decline in my memory all these years but now it has hit rock bottom.
Of what i read on these forums i have the following two options.
A. Start trt and lower Shbg and increase free t to optimal level.
B. Attempt Hpta restart starting with Hcg (But using HCG will escalate Shbg)

I have the following questions
1.Do i have anything left to restart?
2. Have my testes survived in all these years or leydig cells inside the testes die due to low lh supply in all these years.
3. What is the best course of action in the current stage?
Please help.

A restart is not your issue. I know it may not seem like it, but one 50mg testosterone injection 8 years ago is not the problem. Your total testosterone is not terrible. You are making it. Lower free testosterone and higher SHBG are your issues.

They are surviving.

You need to triple your free testosterone. I don’t think you can do that without TRT. You did not ask, but your free T3 of 2.9 is something to look into as well.

Do i have to stay on trt for lifetime or will i be ever able to recover?

TRT is for life and isn’t a panacea, but does give you the tools needed to make improvements to your life. Restarts are for those on TRT with suppressed HPTA, your HPTA is functioning and quite poorly I might add.

Your testicles are not the problem, your pituitary gland should see a demand for more testosterone and therefore increase LH and that isn’t happening. Ten years ago it was unheard of for a man <30 to have low testosterone, in the last 10 years doctors have seen a new tread, men of all ages are being diagnosed with low testosterone.

TRT is your only way out and do not understand why men contemplate stopping TRT years later and return to the state they were in prior to TRT. You have a disease and like all diseases, it needs treatment.

Recovering naturally is not possible, your pituitary is diseased.

I would slightly disagree with you over here. I was doing absolutely fine untill i injected 50mg test enanathate 8 years back. My hormones have been messed up since then. I asked for the restart because i can see my lh is low. I assumed increasing my lh would drastically improve my T.
The use of nolvadex can work in younger men with no pituatry failure.KS man approves that in Hpta restart sticky.
Here is a study to back my claim : Effect of lower versus higher doses of tamoxifen on pituitary-gonadal function and sperm indices in oligozoospermic men - PubMed

That was 8 years ago, if you were going to recover, it would have happened by now and for the fact that is hasn’t… Clomid will increase LH but will more than likely not provide any relief in symptoms.

Restarts can work if the cause of low testosterone is addressed, but the cause in your case is known, exogenous T is the cause. Your response to a single T injection suggests your pituitary was already very fragile and the exogenous T broke it.

An increase in Lh would increase Testosterone if testes are working fine. Then what made you say that there won’t be any change in the symptoms even if clomid increase lh ?