I’m a 33 male. I received blood work results indicating very low free testosterone levels of 129 pmol/L (normal range 200-600), high SHBG of 64 nmol/L (normal range 15-50), and normal to low total testosterone of 10.3 nmol/L (normal range 6.0 to 28.0).
The symptoms I have been experiencing are low libido, rarely do I get morning wood (although I do get erections when aroused, and am able to climax without issue), anxiety (may or may not be related!), very boney physique with little muscle despite daily exercise, insomnia (may or may not be related), and extreme fatigue. Despite being thin (63kg) for my height (182cm), I have immutable fat around my waist: a very feminine characteristic. I’ve dieted for years and have never been able to lose this fat. I also have acne (at age 33!) despite taking care of my skin and applying benzoyl peroxide every day (I’ve tried a bunch of other treatments, too).
When I was around 20yrs old, I had mild gynecomastia which I addressed surgically.
I have been on a keto diet for about 12 months (and have lost a few kilos I’ve never been able to lose before, but I look even more boney than I did before I started!).
My thyroid has been examined and cleared (the results I’ve attached indicate my TSH was a little low but this has now moved into the normal range following a subsequent test).
My GP initially brushed off my low free testosterone and my high SHBG, but when I pressed him, he suggested that I should see an endo. I saw the endo (Australia) and he told me I did not have a Testosterone problem. He basically attributed my physique, and my problems, to my “genes”. I found his answer to be thoroughly unhelpful.
I will be having more blood work done soon to see if my levels have changed.
Assuming my new blood work is the same, what sort of treatment regiment should I consider given my results (I know I should be asking this of my endo but he is terribly unhelpful and I feel that this community has more knowledge about this condition). My primary goal is to increase my energy levels, and, if possible, improve my muscle mass. I would like to adopt a conservative approach, and one which will not shut down my nature T production or lead to any long term complications (i.e. I do not want to look like a body builder - that is completely unobtainable for me with my lanky physique - I just want to look and feel healthier).