Fair question, and no offence taken. The whole point of being here is to discuss and learn.
Ignoring the overwhelming desire to feel normal again (which I did in so far as it's possible for a human to do), the data-driven factors to try TRT were 1) my LH level which is getting close to double the top of the range and 2) sub-optimal free T because of the high SHBG level. The latter has been a problem for a long time, in fact as I noted previously this was a low(ish) SHBG reading for me as I've clocked well into triple digits previously.
Regarding the LH level, and this was part of my consultation with Dr. Saya, my body is essentially asking my testes for more testosterone and putting them into overdrive, but it's not enough to get my free T into an optimal range - either numerically or symptomatically. We don't know why the SHBG is so high. It doesn't appear to be a liver problem, I'm not anorexic, no estrogen use, no signs of thyroid problems. That leaves the most likely explanation as genetics which isn't something that I can control.
So we try to get my levels up to a point where I experience relief from the symptoms.
That's probably a very simplistic response to what is a complex question, and an even more complex set of systems that are involved. It's the best one that I have for you though.
