Low T Symptoms, "Low-Normal" T Levels

Age - 27
UK Resident (US Born, Canada Raised)
Height - 6’1"
Weight - 284.6lbs
LBM - 201.5lbs
Waist - 42"
Body Type - Endomorph; thick facial/lower leg hair, thin on chest/back, balding patches on thighs, hair seems thinner on head than recent years
Fat Carried - Almost entirely in the abdomen and chest, mostly lower abdominal, some inner thigh
Growth as teen - Most vertical growing finished by age 15, continued to “fill out” until ~20
Testes Ache - no
Mood - Mid to Low, no real high moods to speak of; issues with clinical depression since early teenage years (diagnosed and medicated at 24)
Libido - Low
Temperature - normally always feeling too warm, lately have been catching chill more easily - measured temperature ~35.7 C morning, ~36.5 afternoon
Dry Skin/Brittle Nails - No/Yes
Iodised Salt - No
Rx - Currently Fluoxetine HCL 20mg 1/day, previously Venlafaxine HCL 37.5mg 2/day reduced to 1/day
Energy levels - Mid to low, often very fatigued (currently undergoing treatment for obstructive sleep apnoea)
Muscle - decently muscled, difficulty gaining in recent years
Weight Trends - Difficulty losing weight, quick to gain - overweight since teen years
General diet - currently flexible but calorie controlled (currently ~2750 kcals), have experimented with keto diet in past
Concentration/Focus - persistent brain fog
Confidence/Anxiety - middling confidence - consistent with rest of adult/teen life, have been experiencing anxiety when it wasn’t an issue in past
General Health - good
Recent Antibiotics - Antibiotics last taken May/June 2018 for strep throat
Chest size/Sensitivity - 46"/not sensitive
Erections - morning ~2x per week, random rarely, issues achieving when getting intimate
Daily Supplement routine - Iodine Drops (7.5mg Iodine, 15mg Iodide), Vitamin C 1000mg, Vitamin B Complex (Thiamin 91mg, Riboflavin 50mg, Niacin 50mg, B6 41mg, Folic Acid 50ug, B12 5ug, Biotin 50ug, Pantothenic Acid 69mg, Inositol 75mg, Choline 75mg, Para Aminobenzoic Acid 50mg), Vitamin D3 2500 IU 4/day, Omega 3 300mg (180mg EPA, 120mg DHA) 3/day, Creatine Monohydrate 5g, Caffeine 200mg (plus ~2 coffees per day), Zinc/Magnesium (Vitamin B6 7.4mg, Magnesium Oxide 300mg, Zinc 20mg, Copper 0.4mg), Selenium ~400mg (from Brazil Nuts)
Normal Sleep Patterns - 11:30pm - 07:15am

Recent fasted blood test done on on 17th April at 09:19am, I requested the full panel recommended on the forum here, but my doctor stated that she was only able to order a limited panel, and tested the following:

C-Reactive Protein: 1mg/L
Testosterone: 16.5nmol/L (475.893ng/dL)
SHBG: 25nmol/L
TSH: 1.39mU/L
Free T4: 11.6 pmol/L
-Full Blood Count-
White Blood Count: 7.7
Red Cell Count: 5.37
Haemoglobin: 152
Haematocrit: 0.470
Mean Cell Volume: 87.5
MCH: 28.3
Platelet Count: 329
Neutrophils 3.7
Lymphocytes: 3.3
Monocytes: 0.6
Eosinophils: 0.12
Basophils: 0.1
Nucleated RBC: 0

I’ve asked the doctor to refer me to an endo to try to talk to somebody more specialised, but after receiving these results, she refused to do so (unsure if it was that she was unwilling or unable to refer me given the results). She instead recommended me to a local clinic that deals with “problems of sexual functioning” (nothing more specific given, have yet to contact this clinic - supposedly a 7 week wait). I’m unsure of what to do at this point, or what’s needed for me to start feeling optimal. My levels are “normal”, but I know the loaded statement that is.

Nine times out of ten if you go to an ordinary managed healthcare or state healthcare doctor you will get quacked by someone with almost no knowledge in sex hormones and limited testing which doesn’t paint a complete picture of you hormone status.

Your doctors should be testing the free portion of testosterone and not the bound hormone that isn’t bioavailable. Most doctors are clueless in sex hormones and are only managing a number within reference ranges and lack true understanding in sex hormones.

Your free testosterone percentage is 2.43 % and while your levels appear normal if you compare yourself to everyone else, it may not be normal for you. These are tactics state healthcare systems use to deny treatment do to limited resources.

If you don’t have enough testosterone for your body to function normally, forget about normal erections, this clinic will not be able to help if the problem is low testosterone.

Canada’s healthcare systems sucks big time and is the most difficult place to get TRT, often doctors are completely clueless. There are private clinics you can get TRT, but you will have to pay out of pocket.

Thanks for replying - so looks like my best bet would be to go outside the NHS if I want to get any kind of appreciable help.

I’m not entirely sure what the next step would be there - try to find some hormone specialising clinics and doctors?

The NHS is a waste of time, there’s no way they will approve you for TRT because they have refused men with much worse numbers than yours. Balance My Hormones is in Dorset and is a telemedicine clinic.

Canada and the UK healthcare system are virtually identical, so you didn’t trade up by moving to the UK in this regard.

Google “TRT Wars – How to Get TRT in the UK”