As soon as I saw high LH I thought high SERM dose without knowing anything else. The high LH/FSH is driving high T–>E2 inside the testes and Arimidex/anastrozole is cannot control T–>E2 inside the testes as T levels there are too high for a competitive AI to work there.
Doctors do not know this, it took an engineer [me] to figure that out!
One needs to only understand the essence of what “competitive drug” implies and know that intratesticular testosterone levels can be up to 80-100 time higher than serum levels.
So your dose of Clomid is too high for [you]. Also possible risk of desensitization of LH receptors.
So Anastrozole cannot fix this. You must use less Clomid. If resultant T levels are too low, then you need to start T+hCG or T+[low[er] dose Clomid]. Higher dose hCG has same problems.
FT levels could be higher for a TRT context.
DHT is not a concern unless you have genetics for hair loss.
Should not test LH, should test LH/FSH together! LH levels change too much. FSH is a better indicator of LH status than LH itself because of half-life differences.
Please print this off for your doc. I can tell that he is really trying to help and I am always happy to assist.
Clomid/Nolvadex are cheap. T injectables are cheap. hCG can be more of cost concern. There are multiple ways to skin the TRT cat. Your doc seems to be wanting to spare you the burden of self injecting. Injecting T/hCG with insulin needles is really not a problem.