Hi,
I’m really not sure how to proceed.
Stats:
M39 177cm 74kg about 15% - 17% BF
Do not currently drink alcohol or do any drugs. Non smoker. Drank heavily for a decade prior to 2018 when I quit completely. Clean bill of health after quitting drinking (liver enzymes and heart all fine). Have always been good at regular cardio (cycling). Took up weight lifting in 2018 and have been doing that at least 4 times a week since then (plus a couple of days of cardio). Pretty ok diet I reckon.
After I quit drinking in 2018 I unsurprisingly felt great after years of feeling lousy due to excess alcohol. All through 2019 I had more energy and drive and ability to concentrate, and was making ok progress in the gym lifting weights. I really felt I had a new lease on life.
At the very end of 2019 / start of 2020 I started noticing tiredness and fatigue, brain fog, and felt like I was waking up tired / not rested, and getting tired more easily throughout the day, and generally everything was starting to feel like more of an effort. Libido and sexual function still ok at this time. I don’t think there were any external circumstances that might have caused this, it was pre-covid so that wasn’t a stressor that could have caused me to feel like this.
I went to the GP (I’m in the UK) who ran a blood test to check for the usual things that might cause fatigue and tiredness, and apparently they all came back fine. After this I requested a sleep study in case it was apnea (citing waking up not feeling well rested). I had to wait many months for my NHS appointment and sleep study, eventually this was done and came back negative for apnea (they gave me a device to wear overnight).
After this I decided to take matters into my own hands and in July 2020 got a full lab report from Medichecks, which is here: Results Jul-20 v2
My thyroid TSH was slightly raised in this test, which I raised with my GP, but as T3 and T4 were both ok this wasn’t a concern for him. Prolactin was also raised but only slightly (no where near enough to indicate prolactinoma and it can vary a lot between tests anyway). Testosterone was low normal at 14.1 (equivalent to 400ng/dl in USA terms!) - I had told myself if it was closer to 350 I would consider private treatment. All the rest of the results are there if anyone wants to take a look!
Unsure how to proceed I just carried on with my life basically, I made little progress in the gym in 2020 despite eating plenty and putting in a good effort, at least I thought so! I feel like I gained mostly fat during my 2020 bulk, and then had difficulty cutting belly fat during my subsequent 2020 cut.
By Jan 2021 I felt my symptoms were a bit worse, generally tireder / more fatigued. At this point if I went out for a gentle walk for a few hours or spent time cooking a more complex than usual dinner I was basically wiped out for the day, I just about have the energy to do my day job and get my 4 sessions a week in the gym, I am very fortunate that I can work from home due to covid and have a home gym, so only need to roll out of bed and drag myself to work and to the home gym!
I also noticed a drop in libido, I am still good to go a few times a week but I am starting to feel less interest, i.e. I’m doing it because I feel I should want to rather than because I actually want to, if that makes sense.
So I got another blood test, just male hormone this time rather than full panel, that is here: Results Jan-21 v2
In this test prolactin is still raised (but again, only by a little bit), and testosterone is actually a bit higher at 15.3 - I do notice that free testosterone has dropped from last time (and apparently that’s the one that matters - it is now at 0.337 nmol/l (range 0.2 - 0.62) but still within range. So given these results I am still unsure what to do and so take no action.
Finally that brings us to Apr-21 where I’m feeling no better and generally worse, I remember I did have a high TSH back in July-20 and wonder if maybe that’s got worse / my other Thyroid markers have got worse, and that will explain my deteriorating symptoms, so I get another Thyroid only test which is here: Thyroid Results Apr-21 v2
Not much to say as now it all looks fine and everything is right in the middle of the range, TSH is back to 2.4 and T3 and T4 are all good.
I’ve been fortunate enough to have a pretty relaxed life over the last year during covid, my WFH job isn’t that stressful and I am in a good situation financially and in a good marriage, so I don’t think my symptoms are due to depression / mental health, but you never know I suppose. I feel I am lucky things have been so laid back the last year, as I don’t feel like I have had the energy for anything more, I am somewhat dreading returning to normality with social engagements and music festivals and other such events, things I would have relished in 2019, but am now feel I just don’t have the energy to deal with.
Honestly I feel cheated / unfair how I try and get my health in order by quitting the booze, I get a taste of what life is supposed to feel like, then I start feeling like this, it’s really quite upsetting 
I really don’t know what to do. I am half considering contacting Dr Savage at the Ledger clinic (I’m in the UK) and ask if I might benefit from a trial of TRT. But given my ok-ish numbers maybe it’s it’s nothing to do with Testosterone levels at all.
I appreciate this is a massive block of text but if anyone has any insight or advice or anything else I could try / any other tests I could get done, I would be very very grateful.