Dear Dr Topiwala I have felt depressed, low energy, low libido and generally down for a long time. I am now 25 years old and requested that my doctor test my testosterone levels. The test score was 9.5nmol (9 - 25) and i have been referred to an endocrinologist in June. I would like some thoughts as to whether this testosterone level might be causing my mood and what your thoughts are on the different approaches to treatment. I have read that direct testosterone replacement may be an option but that it can shut down the bodies own supply without supplementation with HCG? I have also read that the increase in testosterone levels can cause an increase in oestrogen and cause negative effects. Would you recommend any anti-oestrogen? Finally, I have read some recent research recommending that Clomiphene Citrate can be used in certain cases as a long-term solution to low testosterone. What are your thoughts on this? Any advice would be much appreciated as I would like to be well informed when I go to see the Endocrinologist. Many thanks in advance!