Once the serum testosterone levels are found to be in the subnormal range, it is necessary to know if the problem is at the level of testes or elsewhere up in the chain. Therefore luteinizing hormone (LH) is measured and depending on its value that helps arrive at definitive diagnosis, appropriate medication is administered. If the impairment is at the testicular level, then one can give testosterone therapy. The choice of testosterone therapy is between conventional injectable depot and new oral formulations. When oral preparation such as Andriol Tetocap is used, it bypasses the liver and has minimal effect at that level; thus LFTs need not be tested that regularly. However prostate must be kept under close watch. In your enquiry, there is no information on the duration of Andriol Testocap use. Generally a maximum of 160 mg (i.e. 2 caps twice daily) are given for no longer than 3 weeks and depending on response, the dose is reduced to about half (80 mg daily). Levocarnitine (sold under different brand names including Forage) is indicated in proven cases of carnitine deficiency which mainly occurs in kidney dialysis patients, but can be present in other cases also. There is no known, proven use in cases like yours. There is absolutely no problem in using Penegra on SOS basis since its mode of action is quite different.