Sounds like you “might” be a candidate for HGH injections and possibly testosterone. You can get it in pill form but its nothing like the injections, not even close. But not HGH true HGH is injection only.
I’m no doctor either, but my guess is its 50% mental and 50% low testosterone. I have a friend who when he was 36 had the same problems minus the aches and pains. He was tired and had zero sex drive. He even quit working out. Very fit man. I believe he was able to receive HGH, but testosterone was in pill form. Its extremely hard to get HGH. Also i don’t know if anything factored in for him to receive the HGH either.
It seem to work for him from what he says, and I believe now he takes a form of testosterone for when he works out “not prescribed”
If I was in your shoes, I would hit one of the doctors you have been to the most, the one who knows you and what has been tried personally and request this.
Do not give up friend. With medicine today they say 40s is the new 20s. Factoring out obesity, a typical fit 40 year old today, has the health of someone in their 20s about 30 years ago. It was a special I watched, very motivating to people like me who worry about aging. The legitimacy of it who knows, but it made me feel better =)