High SHBG, TT, LH, FSH and mild hypothyroidism

[Alexanders]

Hello! I’m a 25 years old male, athletic and eating healthy. I’ve suffered from symptoms of endocrine imbalances and signs of testosterone deficiency since I was a teen. The symptoms are lack of energy and motivation, brainfog, mild depression and mild OCD. Last year I was diagnosed with idiopathic hyperprolactinemia, after being diagnosed with galactorrhea and gynecomastia. What’s weird is that my LH is high too, despite prolactin being high. I’ve been on dopamine agonists, that have lowered my prolactin, buy beside that they have made no difference at all.

This is what my bloodworks look like:
Testosterone: 27 (august 2021) 26 (october 2021) 24 (mars 2022)
Reference 12-31

SHBG: 54 (augusti 21) 48 (oktober 21) 53 (mars 22)
Reference: 15-55

Testosteron/SHBG index 0,50 (august 21) 0,54 (october 21) 0,45 (mars 22)
Reference 0,40-1.50

Prolactin: 920 (june 21) 2760 (august 21) 11 (mars 21)
Reference 65-405

LH: 16 (august 21) 7,6 (october 21) 13 (mars 22)
Reference 1,7-8,6

FSH: 12 (august 21) 12 (october 21) 13 (mars 22)
Reference 1,5-10

TSH: 3.1 (june 21) 4.6 (august 21) 6.6 (mars 22)
Reference 0,4-4,0

T4 free: 17 (june 21) 19 (august 21) 15,1 (mars 22)
Reference 12-22

T3 free: 4,8 (august 21) 4,6 (mars 22)
Reference 3,1-6,8

ACTH: 32 (august 21) 27 (mars 22)
Reference 1,5-14

Cortisol 558 (august 21) 487 (mars 22)
Reference >350

IGF-1: 270 (august 21) 268 (mars 22)
Reference 113-320

DHEAS: 12 (october 21)
Reference 3.3-13.9

Progesterone: <1.6 (october 21)
Reference <0,6

Albumin: 46 (october 21)
Reference 35-50

Estradiol (non-sensitive): 89 (october 21)
Reference <120

My approach to this is NDT for hypothyroidism and TRT for primary hypogonadism and/or androgen insensitivity, is this the right approach based on my bloodwork and symptoms?

 

[PeskyPeater]

seems like hypogonadism [bc FSH and LH are high], not sure about hypothyroidism, those are free t3 t4 values I ingore them they are meaningless. But TSH is high so this can be indicative for hypo. But you have to know your waking temp and BPM and between 11h and 15h...

I would start NDT but I cannot recommend TRT I do not have experience with that. does not seem safe as it can convert to estrogen.

edit: I now see the ACTH is high, this can be from low oxidative respiration from hypothyroidism.

 

[Motorneuron]

I remain of the opinion that the analyzes of the hormones in the serum have very little success ... why can't they do analyzes on the cerebrospinal fluid?