Well first of all testosterone is too high and that can cause feeling of wanting to “fly off the handle”.
So you want to get that in range by working with your endocrinologist to find the right level for you.
If these bloods were taken when you have only just gone onto TRT then I would not use them for altering the dose because you can expect the HPTA negative feedback and the effect of aromatase and estrogen conversion to alter those numbers and you need to alter meds based on steady state numbers.
When you have been on the gel for a couple of weeks then you could take the numbers to be steady state and base dosing on that.
When you have reached that point where you can dose for good numbers that feel best from a symptomatic point of view after a few weeks;
I would not expect libido to just click back into place, this is not turning on a light switch.
Libido can take months on the right dosage and hormonal levels to come back for some men.
You want to keep taking the hypogonadal checklist and see how you fair on it with the passing of time. Hopefully you will generally start feeling better in yourself and libido will come in time.
If you do not find a level of medication that you feel well on then you have to start considering various matters.
Is DHT a problem?
Is estradiol/estrogens a problem?
If you get very emotional and a tender chest- sometimes feeling like the chest is tingling and seeming to grow that would suggest possible gynecomastia development and irrespective of the pathology numbers that would mean that your estradiol is possibly too high for you.
If this is the case and DHT not low and fre testosterone quite good then you ned an endocrinologist who will consider small amounts of an aromatase inhibitor.
If none of this works you may consider differing forms of TRT. I have known men do very badly on one form of TRT and great on another, it is very much a case of horses for courses.
If you reached a stage where TRT fails irrespective of dose, form and ancillary meds then you can consider HCG, Clomipehene or even an aromatase inhibitor alone to see if any of those lead to symtomatic improvements, well-being and the return of libido.
You have to start somewhere and you have, this could be quick and easy or it could be very difficult. Time and experience with these problems has suggested it maybe the latter.
