28 Y/O, Started TRT. Looking for Advice

Hello.
I’m hoping to get some thoughts, / advice fro those who have been through it all.
I’m 28, 32inch waist, 73kg.
Up until a year ago I was plenty active enjoying martial arts, going to the gym, active sex life. Then it started declining and I became lethargic, demotivated, foggy brain. I sleep 8 hours but wake feeling unrefreshed

Tested ok for sleep apnea, rheumatology. Vit D was a little low but is now back to normal 110nmol

I had a hormone test which came back with:
D.H.E.A.S 10.6 umol/L (0.44-13.4)
FSH 5.2 IU/L (1.5-12.4)
LH 4.9 IU/L (1.7-8.6)
Testosterone 10.5nmol/L (7.6-31.4)
Free T 0.18 (0.3-1.0)*
SHBG 38 nmol/L (16-55)
17-beta Oestradol 133pmol/L

Some other general labs that are fatigue related.
Active B12. 78pmol/L (25.1-165.0)
Folate serum 6.7 ug/L
Iron 26.3 umol/L (10.6-28. 3)
Ferritin 125ug/L (30-400)
TSH 2.88 mIU/L (0.27-4.2)
Free Thyroxine 17.4pmol/L (12.0-22.0)
Free T3 5.6pmol/L (3.1-6.8)

Endo has put me on testogel pump. 2 pumps a day. Been on it a week, had a few erections but still very fatigued.

One of my balls appears very small and I have some lumps (on the tubes, not the ball) . Awaiting an ultrasound

Diet has improved vastly over the last few months. I try to go to the gym 2x a week. But self motivation when fatigued is very very hard. Feel like a shell of my former self.

I don’t know how long the gel might take to make the fatigue better. I know I’m only a week in.

Anybody have thoughts on my symptoms / results. Or experience something similar and can talk about it?

It would be such easier knowing there is light at the end. Though I don’t know for sure if my T has been causing my fatigue. I hope it has. So i can fix and start feeling better.

Thanks.

Bob

It’s important to manage and monitor estrogen using the sensitive estrogen test designed for men, if elevated it can cause testicles to pull up tight and cause mood swings and irritability. If your doctor is unwilling to manage and monitor estrogen (common) find another doctor.

My Vit D was low when T was low, restored T and Vit D corrected itself. You need reverse T3 tested, it might help explain why TSH is elevated. TSH should be closer to 1.0, that’s where all healthy young men score. Doctors only care about in range, problems is you can have problem within ranges.

You won’t find many here on gels, injectables are 100% absorbed and requires the most doctor skill. Most men don’t absorb gels very well.

Are they looking for a vericocele?

Yes, do you know much about them?

I do. I had one and needed surgery to get it corrected. I don’t recall what the parameters for surgery were, but mine was considered to be bad enough that they didn’t want to wait.