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Furthermore, during infectious processes in ME/CFS patients, both increased proinflammatory cytokines and increased oxidative and nitrosative stress due to activation of microglia via TLR3 could lead to increased IDO activity in microglia, resulting in reduced tryptophan levels (increased its catabolism), increased kynurenine catabolites, and decreased 5-HT and melatonin synthesis [366, 367]

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Upper arm: The back of the upper arm, between the shoulder and elbow

Of note, BH 4 is also a cofactor of phenylalanine hydroxylase, which converts phenylalanine to tyrosine, a precursor to catecholamines

Thats one aspect of testosterone but its only a minor part of it