Can you get his complete lab results? Typically we look at Total Testosterone. Need LH and FSH too. Estradiol is useful as well.
Now let's talk about your initial question, what's the best thing for him to do.
You need to try to get to the bottom of what is causing his Low T (if he has Low T). This is also known as hypogonadism. We need to see his labs. Free T is useful information, but not a good measure of whether or not someone has hypogonadism. There are lots of things out there than can cause hypogonadism or give the same symptoms.
- If he has hypogonadism, is he primary or secondary? This means, does the issue lie with his testicles not working or his pituitary gland not working. LH and FSH will help us determine this. - Any traumas to the testicles? Any trauma to the head?
- Need to check his thyroid. Get a full panel done. TSH, T4, FTI and T3 Uptake.
- Could he have sleep apnea? Does he snore? Is his neck >17 inches? Is he over weight? Does he still feel tired after a night's sleep? If he has any of these signs, he needs to have a sleep study done. Not getting quality sleep can decrease your testosterone a lot.
- How is his diet? Lot's of healthy food?
- How much sleep does he average per night? I know when I was 20 I wasn't getting my 8 hours on a regular basis.
- Check Vitamin D levels (blood test). Low vitamin D can make you feel lousy and lower your testosterone.
- Are his cholesterol levels healthy? Not too high or too low?
- Check for anemia.
- What's his body fat % approximately? Go to this link and scroll down the page a bit to see the % guide.
Body Fat Percentage - Healthy Grad
- Any history of depression?
- Has he developed masculine features? Beard growth? Muscle development? etc...
- Check prolactin (blood test).
If you don't want to go through a doctor, or save money, you can get lab work done at
Private MD - Buy Lab Tests Online. They are much cheaper and provide results usually in the next day or two. I like to search on the word "panel" as these are packages of tests that are cheaper than buying them individually. A good one to start with is would be the Hormone Panel for Males in your case. It includes:
- Lipid Profile
-Complete Blood Count w/ Differential
-Estradiol, Sensitive
-Insulin Growth Factor (IGF-1)
-Comprehensive Metabolic Panel
-Testosterone (Free) , Serum (Equilibrium Ultrafiltration) With Total Testosterone
-Prostate-Specific Antigen (PSA)
-Thyroid Profile
And then add the following tests:
- Anemia Profile Advanced: Iron with TIBC; reticulocyte count; ferritin, serum; folic acid, serum; Vitamin B12, serum.
B12 is another good one to check as it can affect energy levels.
- Prolactin
-Vitamin D, 25-Hydroxy
- Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)
I know this seems like a lot, but it really should help you get to the bottom of what is going on. If you go through privatemd it will cost you $300 after the 15% discount. Here is a coupon code. efewr34j
Now, I know this is a lot of money. If you want to get the bare minimum for just seeing if he has hypogonadism, you can get the Hormone Panel for Females. Despite the name, it is for men too. It costs $50 after the discount. But this one won't help get to the bottom of what may be causing his hypogonadism if he has it.
Lastly, let me say that there are ways to restart his Testosterone production again if he has secondary hypogonadism. You would definitely want to explore that before beginning testosterone replacement therapy (TRT) at age 20. testosterone replacement therapy (TRT) means injecting test for the rest of his life. It is a life saver if you need it, but we would all prefer to have a natural test production back.
Good luck and keep us posted. Sounds like you are a good girl friend.
