Hypogonadism and the AACE guidelines
liftr486-it sounds as though you have hypogonadism, and due to the fact that you respond well to the SERM clomid and after looking at your on and off clomid lab results, the diagnosis would likely be secondary hypogonatrophic hypogonadism. This is where the pituitary does not release adequate amounts of LH and FSH.
I also agree that your on clomid E2 levels are too high and that your doctor should prescribe arimidex or some other AI for you. If you have too high of estrogen, it will negate most of the anticipated positive effects of raising your testosterone. I like mine to be in the 15-20 range. Your mileage may vary.
The other type of hypogoandism is hypergonadotrophic hypogonadism or primary hypogoandism. In this case, the Hypothalamus and Pitiuatry are working and often over working trying to raise testosterone in the body but the testicles will not respond to the LH and the FSH. Unfortunately for men who have this condition, having their own children is all but impossible. Also they are going to require liftetime TRT.
There are several reasons why men young as yourself develop this condition, and there are several causes for secondary hypogonadism. They range from pituitary tumors and genetic anomolies to severe head injuries.
As one female has posted on this thread, it is worth pointing out that women also have hypogonadism problems as well.
If your doctor has not done some of the testing to find out why you have low T levels, he or she is not practicing good medicine and i would recomend you find a new doctor soon. Or in the words of Don Trump--You're fired!!!!
1. Has your doctor checked your prolactin levels?
2. Has your doctor done an MRI of your head to look at your pituitary and hypothalmus?
3. Have you had a genetic evaluation?
4. Have you had or do you currently have gynecomastia (real gyno) with signs of actual breast tissue and duct development?
5. Have you had a severe head injury?
6. If this has been going on for a long time, you may be on the road to developing osteoperosis, but at your age it would be unlikely.
7. Are you smoking weed?
8. Are you taking any psychotropic medications?
9. Are you taking any other anabolic steriods at this time or during your clomid cycles?
Search the internet and look for the AACE Treatment guidelines for male hypogonadism. If your doctor is not offended by such, bring a copy of this document to your next appointment. If he or she is not familiar with this docuement and the clinical work behind it, they have some catching up to do. If they will not read the AACE treatment handbook, then I would get rid of him or her as my doctor.
There is far too much urban legend and flat out false information regarding hypogoandism and TRT on the body building boards, and if you truly have hypogonadism, you do not want to fool around.
Life Extension and Dr. Chrisler at all things male also have some good reading material on the subject of hypogonadism and TRT.
As was pointed out by a previous response, if your problem is with the intereraction between the pituitary and the hypothalamus, you may have problems with more than just your gonadatrophins ie LH and FSH
If you are trying to use hypogonadism as a means of getting roids for cycles, the good doctors who know TRT and HRT are not going to keep you as a patient. They have no time for patients who are playing games with them.