I see hypothyroidism, not major, but considering everything else, it might be contributing more than one would expect. Do you use iodized salt? Iodine in vitamins? Check body temp when you wake and mid afternoon and report. If you have an iodine deficiency, then that needs to be treated with iodine replenishment. If body temps are low, one can try iodine replacement. If that works, great, otherwise explore treatment with thyroid drugs to restore body temps. Your TSH sucks. Do not accept your doc stating that that is normal. It is normal to find people with thyroid problems that are not been treated and that creates a normal range. Where you are is not optimal.
should be getting iodine in your seafood, but may be loosing iodine in parallel with your iron losses. You may be deficient in other trace minerals as well, get a vitamin that has trace minerals and high potency B-vit complex.
You may be picking up mercury with the sea food that you are eating. Get tested. Mercury gets concentrated at the top of the food chain. Farm raised salmon might be safer if there is substantial vege content in their diet.
You have many hormone deficiencies: T, E2, progesterone, pregnenolone, DHEA and others.
Start taking 2x25mg DHEA per day, will reduce if your E2 over responds.
Google for pregnenolone caps, you have low pregnenolone and that affects the adrenals and the brain.
These are hydrophobic. Take with oily food! Take with a large amount of fish oil. You diet sounds very EFA deficient. Also use olive oil and eat olives. Do not take high fiber foods with healthy fats as absorption will be impaired.
Report your cholesterol lab results or get tested after a 12 hour fast. Low cholesterol rate limits all of your steroid hormones. If cholesterol is low, you will need a high cholesterol diet. Study this! http://en.wikipedia.org/wiki/Steroid_hormone
Eat nuts and add ground flax seed to food.
Take 5,000iu vit-D caps, tiny oil based caps at Walmart or elsewhere. Do not get dry caps. Start taking 25,000iu for two weeks, then down to 5,000. Later on you can test vit-D25 to see what your levels are.
We have seen extremes of diet and training cause problems similar to yours. Starvation can do terrible things and some are permanent and http://en.wikipedia.org/wiki/Epigenetic_theory in nature.
Starvation also lowers thyroid hormones and the stress of starvation increases RT3 - as can any stress or long term infection/inflammation.
"The weird thing is, it's just hard for me to think of my whole situation as one that should be accompanied by a sense of urgency. "
-define apathy, and you get apathy with hypogonadism
How large are your testes, how changed and how are they hanging?
Please note all items that need a reply
You are spilling iron and the body does not do that naturally. You can be loosing iron from intestinal conditions or diseases where bleeding is occurring. Get tested for blood in your stools or urine. If nothing there, perhaps a lab needs to look at your blood with a microscope.
Before starting with testosterone, you need a SERM challenge to see if your pituitary and hypothalamus can play the game. Either clomid or nolvadex could be used, but some react adversely to clomid [read]. Take for one month, note changes to how you feel and testes. Then test E2, TT, FT, LH, FSH, DHEA-S, pregnenolone. If things are working well, you can keep going then after another month, taper off of the SERM and see if you can restart your HPTA. If you do not respond to the SERM, there are serous problems that might not be surmountable then you can try hCG monotherapy, which can work well for younger men. If that fails, start a standard T+AI+hCG protocol where AI is adjusted to get near E2=22pg/ml.
If you get your T levels useful with hCG, stop the DHEA and test for DHEA-S after 3-4 weeks to see if you are making enough.
Note that if LH increases or hCG is used, T production depends on DHEA for a raw material. If DHEA does not recover, you must supplement for hCG to be effective as DHEA-->T can be rate limited by low T.
You need to monitor E2 as some hyper covert DHEA-->E2, probably in the adrenals and DHEA dose may need to be adjusted or eliminated. And same for hCG, which can lead to high E2 production in the testes for a few on normal hCG doses. High hCG doses makes this very likely. Do not let a doc put you on more than 500iu hCG EOD. And huge doses of SERM can make LH too high, creating the same problem. And do not stack a SERM and hCG.
Print and read, do research, show this to your doctor to discuss lab work. You tagged me for my input. You have a lot of work to do and you cannot be passive. You need to manage your own health care.