I think that your low energy is mostly thyroid related.
TSH should be nearer to 1.0
The lab range for TSH covers a 10:1 range of levels. This is part of a collective medical stupidity.
This may be a result of not using iodized salt and becoming iodine deficient.
Your energy and metabolism are controlled by fT3 levels which control the metabolic rate of mitochondria inside your cells that make ATP and all of this is also how your body temperature is regulated. So your body temperatures may be low and body temperatures are a very good guide to overall thyroid function.
Check your oral body temperature:
- when you first wake up, should be 97.7-97.8 and higher also good. 97.3 is way too low
- you should also hit 98.6 mid-afternoon
- thyroid basics
- advice for new guys, note 1st paragraph
- protocol for injections
- finding a TRT doc
- things that damage your hormones
LABS: - you have some now
LH/FSH [cannot be done after starting TRT]
AST/ALT [liver function affects E2 and SHBG]
cholesterol [can be low]
vit-D25 [many need 5000iu vit-D3 to get near optimal levels]
TRT now or later? Its all about quality of life. Low thyroid function sometimes causes lower T levels. So there might be some progress with interventions to improve thyroid function; which can sometimes be as easy as getting more iodine. First focus on thyroid issues. If cortisol is low, that is also a energy depressant. We have many guys here with thyroid problems. Less often with low cortisol. But we do have guys here with adrenal fatigue, T and thyroid problems, the three legs of the energy tripod.
Thyroid problems can lead to fat gain. So can low T levels. You probably are dealing with both. If you have thyroid/iodine problems, resolving those may improve T levels, which may not be all that you need.
If your iodine intake has been good or you replenish iodine levels and body temps stay low, one possibility is rT3 blocking fT3. And then there are degrees of thyroid autoimmune diseases, some of which may caused by selenium deficiency. You should have iodine+selenium in a daily multi-vit.
What's the time line for loss of energy and fat gain? Any of that punctuated by stress events, blows to the head, accidents, illnesses?
What is the time line for use/non-use of iodized salt?