Diet: You need to start avoiding simple carbs and processed foods. Rice is not good for your condition.
Diabetes best evaluated with A1C lab results.
How is your weight and describe how it has increased over the years. My concern is prolactin. We normally expect that to decrease LH/FSH but the opposite is happening. Elevated prolactin often leads to a MRI to detect possible pituitary adinoma after a repeat prolactin lab confirms an issue. If adinoma grows and presses on optic nerves, one of the first symptoms is reduction of width of peripheral vision that should be near 180 degrees.
Labs indicate that your testes are the problem.
Do you have high blood pressure?
Did doc examine your testes? any aching?
Prolactin can be inflated by hugging babies, puppies/kittens and orgasms. Was your 21.5 clean?
High E2 might be from poor liver clearance. Test AST/ALT. Can also be from drugs, Rx and OTC that compete for enzyme pathways that clear E2.
Post non-hormone lab results as well.
Insulin resistance can also be driven by low thyroid function, see last paragraph in this post.
What is your history of using iodized salt?
Feel cold easily?
Outer eyebrows sparse?
You could lower your E2 with anastrozole now, but that will increase LH/FSH even higher and the testes are still the problem.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.