*UPDATED* Lab Results- Opinions Needed

OP, if you’re looking for underlying reasons than take a look at your thyroid hormones in detail. Your tsh doesn’t look very good. Read the below sticky for more info

https://forums.t-nation.com/clicks/track?url=https%3A%2F%2Fforums.t-nation.com%2Ft%2Fthyroid-basics%2F185344&post_id=4376507&topic_id=38

Had you tested your estradiol levels too? Your VitD, cholestrol and prolactin issues do really need to be fixed. Read here for more details

Alternative to TRT is SERM therapy, but I suspect how much effective a SERM restart will be for you at age 43. You may have to go long term on SERM to see any benefits, but it is definitely worth a chance if you want to avoid TRT.