Thyroid is not alright, TSH >2.5 usually indicates a problem and you will not be able to metabolize testosterone in the liver with low thyroid hormones which you haven’t even tested yet. TSH closer to 1.0 is optimal. Free T3 is the most potent thyroid hormone, Free T3, (not TSH or Free T4) increases body temperatures and metabolism.
Reference ranges for TSH and thyroid hormones
First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L. On the other hand, upper TSH reference limit is (assay-dependent) usually around 4.2-4.5 mU/L. There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease.
The evidence for a narrower thyrotropin reference range
It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter.
You’ll get no argument from me, testosterone is low. SHBG should be considered before starting or chosing a TRT protocol. SHBG binds sex hormones and when on the lower end, more frequent injections may be necessary.
Your symptoms seem borderline low testosterone, not terrible like most men scoring these numbers. Having lower testosterone can make it to where minor stress turns into a big deal, TRT can make you calmer where the moderate stressful situations are no big deal.
SHBG is most likely in the mid 20’s, enanthate injections 60mg twice weekly, 25-30mg EOD or sustanon 65mg twice weekly is recommended. If having high estrogen sides inject smaller doses more frequently, this will lower estrogen. Stay away from AI’s if you can help it.
Please note, men with lower than normal testosterone have more aggressive prostate cancer and increased mortality (cardiovascular & heart diseases) with many diseases associated with low testosterone.
Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men
These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction.