Do you have testes now? If not, hCG has zero value. I also assume that your are sterile and then hCG to preserver fertility would not apply. hCG is hCG, brand name is meaningless. Otherwise hCG is only ever needed when LH is low, not your current situation.
You need to explain nebido dose and when your labs were done relative to prior injection.
At time of the lab work, LH/FSH were very high, indicating that your hypothalamus was not detecting T and estrogens and was telling your pituitary to produce LH/FSH, or your pituitary is stuck turned on producing LH/FSH. Do you have a pituitary tumor?
Letro and other competitive aromatase inhibitors [AI] [anastrozole]: These need to match serum T levels. Nebido is long acting and levels change a lot. You would be better off self injecting T twice a week to get steady T levels so your AI can work properly.
Your E2 is clearly too high and you need to get near E2=22pg/ml - 80 pmol/L
I cannot recommend what to do without more info. Your E2 is too high, not low enough to fight gyno.
letro 1.25mg ED is a huge dose. Normally I would say that high LH is causing high T–>E2 production in your testes and a competitive AI cannot work inside the testes. I really need to know what your ‘primary’ really means.
With your TT, FT and E2, your production of LH/FSH should be near zero. Something is very wrong.
Please read the above multiple times until you understand.
Your post was extremely well written!
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.