Firstly, apologies for starting a brand new thread. Before replying to the above, just a quick mention about my current situation.
I was indeed put on trt in the end, through the nhs, in the form of Tostran gel 2% (6 pumps daily) applied to stomach and inner thighs as recommended. Pre trt included four lots of blood work. I wish I had the copy to hand, but as an overall level -
testosterone come back low (out of range on all 4 occasions) and is still low 8 weeks after starting treatment at 9.0 nmol/L.
The issue I have, is I still feel like rubbish, and the endo seems happy with the results 9.0 (10-30). Still poor energy, no motivation, low libido, mental fatigue and fog. Just basically really nasty stuff. Was never expecting a miracle. Just to feel better.
3 of those 'pre' trt tests were taken early in the morning around 9am, and one was taken in the afternoon at 1pm. The initial time between the first test and the last pre trt approx was 1 year. So as you can see no fluke.
The full blood profile (including thyroid) on all occasions come back fine (apart from a high rbc which resolved after the initial test), thyroid function was also included as part of a complete pre trt hormone profile panel which also included prolactin, hgh, cortisol etc, the only one they didn't check was oestradiol strangely enough.
Other examinations included complete lifestyle and diet questions, a complete physical which concluded normal testicular function. I'm currently awaiting an mri on pituitary function.
To answer the questions above, I asked about thyroid based on the results and in short - no issues. I do indeed consume dairy products, milk every day, cheeses, yogurt etc. I especially love sea food. In fact my diet is pretty varied. I run multi vitamins and minerals which does not list iodine or selenium. I also run zinc.
No liver issues, labs confirmed this. On no other meds.
However, I have suffered severe anxiety and panic disorder for a number of years, which you would think would drive up stress hormones. It's funny you should mention atp, as anxiety aside, I have suspected an abnormally elevated level of norepinephrine and epinephrine, and have often wondered if and how these two would impact atp and the hormonal balance in excess. However, I have never had norepinephrine or epinephrine measured. Apparently atp issues can also point to a problem with Coenzyme Q10.
Regardless of the fact it's gel, you would now generally expect those levels to be higher than 9.0 nmol/L. Even my gp said we need to be aiming for around 20. So I have no idea whether I'm just absorbing it too poorly, or whether my physical and mental fatigue is another issue as well. Just seems a coincidence that testosterone is still low and my symptoms are still there.
That's why I wondered if something like HCGenerate might help sense of well being and energy at least in the short term?