Should I get further labs to determine what's wrong with me (low T)?

Male, 30, 5’9", 178 lb.

Sedentary, sleep deprived, chronic calorie deficit since April, micronutrient deficiencies.

No morning wood for 3 years, weak orgasms, little interest in sex, only 1 decent orgasm per week. Have problems getting erections. Slight burning sensation upon ejaculation and urination.

Medications: 25mg/week methotrexate, 400mg/day hydroxychloroquine, 1mg/day finasteride (started this month).

Currently overhauling diet.to fix my deficiencies. Can’t exercise due to health problems which I’m currently trying to fix. Sleep deprived due to work schedule. Don’t want to increase calories and get fat since I’m sedentary. Used to be obese, currently overweight. Bodyfat % unknown, probably in upper 20s. If I can fix my tendinopathies, I will be able to change jobs which will fix my sleep schedule and exercise again. I imagine my lifestyle factors are the problem.

Here are my labs

FT4
0.97

0.58-1.60 ng/dL

TSH
0.46

0.45-5.33 uIU/mL

TEST
366

300-1000 ng/dL

I agree with your suspicion that lifestyle factors are far more likely to be the issue here. I do not think additional labs are needed with respect to your thyroid or testosterone levels.

I am curious which specific micronutrient deficiencies were found/proven.

The sleep deprivation is overwhelmingly the main target I’d work on here - there is no medication (and certainly not testosterone replacement) that will fix the consequences of that. Beyond this, it sounds like you are already working on the bodyfat, which is wise.

Thanks for the reply. My micro deficiencies weren’t drawn from the blood test, but they’re tracked in chronometer. I’ve been deficient in B, D, E, K, Calcium, Copper, Iron, Magnesium, Manganese, Potassium, Zinc…almost everything.

Yesterday was the first day of overhauling my diet. Hit every RDA except for Magnesium (70%), Potassium (80%), and Sodium (60% – though I don’t track salt on my foods, so this might be higher – I salt all of my meats).

I wonder if I nocebo’ed myself or if I’m experiencing genuine side effects from finasteride, because the burning sensation and erection trouble coincided with starting the medication. The other sexual problems were already present, though.

Without specific lab evidence, you cannot conclude that you are actually deficient in any of these things - and I doubt you actually are.

Our bodies are quite good at maintaining stores of many of these nutrients, and you would be quite surprised at how well we are able to do this.

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