These cases are always interesting. The first thing to ask yourself is how much these symptoms are impacting your life. Is this affecting your work, marriage, other relationships, enjoyment of life? Only you can make this determination. Keep in mind you’re not sick, many people simply roll through life feeling as you do, so this is an elective process.
Second, take the least invasive route you can. That means diet and exercise. Take some supplements, maybe try gluten free, dairy free, sugar free diets, or all the above. Read the labels? No, if it has a label, don’t eat it. Do some strength training. If that helps your energy levels, you feel better, mood is better and maybe libido is better as well.
There is a saying in medicine that if you think you’re healthy, you haven’t had enough tests. Go to a psychotherapist, you’ll need counseling. Go to your GP, you’ll need anti depressants. Go to a psychiatrist, same thing. Go to a gastroenterologist, you’ll have bowel disease, go to an allergist, you’ll be treated for allergies. And, yes, go to a TRT practice, you’ll get TRT.
Everyone talks about evidence based practice these days, but in the context that means solely following the literature. Aside from the published literature, EBP is a three legged stool, with one being the desires and needs of the patient and the other being the experiences of the clinician. If it’s me, you’d be included in a shared decision making process and with a proper physical examination, a more in depth consultation than we’ll have here, thorough explanation regarding the pros and cons of testosterone, informed consent, and you wanted to try TRT, I’d give it to you. In my experience, you double your total testosterone and free testosterone, you’ll feel a lot better.
By the way, did they check E2? You did not post a result. Assume they did, since recommending an aromatase inhibitor, but I would not take one.