Low LH/FSH is suggestive of secondary/tertiary hypogonadism. These are probably signaling issues at the pituitary and hypothalamus, respectively. These make up a large majority of hypogonadism cases. Unfortunately, after blatant brain abnormalities have been ruled out, along with severe deficiencies (e.g. vitamin D) and hormonal imbalances (e.g. high prolactin) then all you can do is call it "idiopathic" and start treating the symptoms. This is the end result for most guys with hypogonadism.
So the advice hasn't changed from responses to your first post: TRT overseen by a good doctor is likely your best bet. Even if Clomid didn't give you anxiety, your elevated SHBG means that you're less likely to achieve good results with it. You could use it temporarily if you want to bank sperm before TRT. Or you could just take hCG with your TRT and hope that is sufficient.
As "HRD LVN" says, Defy Medical is a good option. And as I've said before, I wish I'd gone with them in the beginning instead of messing around with local doctors who had inadequate knowledge.
testosterone Total: 2.87 ng/dl reference 5.05-19.8
testosterone free: 191 ng/dl reference 240-950
t4 free 1.05 from .93-1.70
t3 free 1.87 from 2.00 4.40
SHBG : 56.
LH: 2.3 FROM 1.70-8.60
FSH:1.48 FROM 1.50-12.40
IGF-1 NG/ML 87,50 FROM 116.00-358.00
prolactin: 13 from 4.0-15
this are my current latest labs. vit d was normal and if you need it let me know. i dont truly know if i qualify for secundary hypo tho. i always thought maybe my diet is bad or needs fixing or maybe my sleep is bad because im not getting 8 hours and constantly waking up too pee and not being able to get back to sleep 20 min after or so. it doesnt matter if i reduce water intake i urinate a lot during the day. constantly feeling cold etc. finding a doc who knows about clomid or hcg is the biggest issue around here. i was wondering of going to a good hospital in the usa to take care of this. i think you remember my adenoma but the best neuro around here said its not the cause of my hormonal issues and its something else (neuro doesnt know much about labs im guessing and endo is the one who rules thisnout) he thinks because prolactin is normal nothing the tumor is not the cause. im a guy who likes to see the doctor in person
main reason im scared to trt is because “what if” i find the cause and can fix it? and also if i would drop trt i might not regain my natural one when i might know the cause of the problem? ultimately. psychologist wants me to put me on low dose of wellbutrin or ssris to counter suicidal thoughts and ocd