Suggest Remedies For Low Hypogonadism Levels
Get SHBG levels done.
Total testosterone levels might be normal with hypogonadism if the SHBG levels are increased. Levels of SHBG increase with age, causing a decrease in bioavailable testosterone. If testosterone levels are low-normal but the clinical symptoms and signs indicate hypogonadism, measurement of serum total testosterone levels should be repeated and an SHBG level should be determined. With the total testosterone and SHBG levels, a bioavailable testosterone value can be calculated.
So there is all possibility that your SHBG levels may be high and hence free testosterone levels may be low and hence no effect seen after replacement.
There Are Various Causes Which Can Cause High Shbg Levels Like:-
Elevated estradiol levels from conversion of testosterone
Extreme weight loss in anorexia nervosa
Certain medications as the Dilantin (a phenytoin)
Any compromise of liver detoxification such as alcohol abuse, certain meds, heavy metals etc. can decrease liver capacity to excrete excess estrogens from the body.
So please rule out these and get the SHBG levels done.
Another possibility is to look for deficiency of enzymes taking part in the steroidogenesis pathway towards testosterone production and if any is deficient then testosterone production would be affected.
TESTOSTERONE REPLACEMENT WOULD BE THE ONLY OPTION AVAILABLE IN YOUR CASE HENCE.
Rest your endocrinologist and physician should consider the possibilities of steroidogenesis enzyme deficiencies.