Shall I move to TRT?

Pharma
1

Male, Height 6’1 ,Weight 83 kgs ,Age 36 yrs

Not planning any more kids.

Hey everyone on T Nation,

I’m new here and wasn’t entirely sure which subforum this fits best—maybe Pharma or Over 35? Feel free to point me in the right direction if needed. Appreciate any insights you can share.

A bit of background: About 5 years ago, my gut took a major hit from heavy antibiotic use and getting COVID twice (fully vaccinated). I’ve recovered a ton since then, but I’m still not back to 100%. I’ve got some ongoing restrictions and sensitivities—I’ve experimented with every diet under the sun: keto, carnivore, vegan, and everything in between. Carnivore helped the most with post-workout recovery after resistance training, but it just wasn’t sustainable long-term for me.

Lately, recovery from lifts has been a real struggle, and I’m wondering if low-ish testosterone could be playing a role. I’m considering starting TRT, as I’ve read it might help with gut issues too (possibly via vagus nerve or neurotransmitter pathways?). Weirdly, even something like perfume can trigger gut irritation for me—docs have mentioned it could be related to vagus nerve dysfunction or neurotransmitter imbalances, but no clear answers yet.

My main symptoms these days include fatigue, negative thought patterns, low motivation, mild anxiety (better than before, but still there), occasional gut burning, and trouble focusing. On the positive side, libido is solid, and I get morning wood 4-5 days a week.

I’m thinking of easing into TRT with Testosterone Cypionate: 50mg/week for the first 2 weeks, then bumping to 75mg, and eventually 100mg if things go well. Before pulling the trigger, I’d love your thoughts based on my recent bloodwork (attached below). Does this scream “need TRT,” or am I missing something? Any red flags in the labs? Tips on optimizing gut health alongside TRT?

Test Name Results Units Bio. Ref. Interval
Testosterone Panel, Total & Free
Testosterone, Free 30.90 pg/mL 12.30 - 46.60
Testosterone, Total 780.99 ng/dL 164.94 - 753.38
Estradiol (E2), Serum
Estradiol 31.70 pg/mL <39.80
Ferritin, Serum
Ferritin 89.90 ng/mL 22.00 - 322.00
Progesterone, Serum
Progesterone, Serum 0.21 ng/mL <0.20
Helicobacter Pylori, Antibodies Panel, IgG & IgA, Serum
H. Pylori IgG 4.62 Index <9
H. Pylori IgA 2.07 Index <9
Thyroid Profile Free
Free Triiodothyronine (T3, Free) 3.50 pg/mL 2.30 - 4.20
Free Thyroxine (T4, Free) 1.35 ng/dL 0.89 - 1.76
TSH, Ultrasensitive 2.783 µIU/mL 0.550 - 4.780
Thyroid Profile Total
T3, Total 0.81 ng/mL 0.60 - 1.81
T4, Total 4.70 µg/dL 5.01 - 12.45
TSH 2.78 µIU/mL 0.550 - 4.780
HLA - B27
HLA-B27, Disease Association Negative
Stool Comprehensive Antigen Screening Profile, ICT
C.DIFFICILE ANTIGEN Negative
CRYPTOSPORIDIUM ANTIGEN Negative
ENTAMOEBA ANTIGEN Negative
GIARDIA ANTIGEN Negative
ROTAVIRUS ANTIGEN Negative
Complete Blood Count (CBC)
Hemoglobin 14.10 g/dL 13.00 - 17.00
Packed Cell Volume (PCV) 42.90 % 40.00 - 50.00
RBC Count 5.35 mill/mm3 4.50 - 5.50
MCV 80.20 fL 83.00 - 101.00
Mentzer Index 15.0
MCH 26.40 pg 27.00 - 32.00
MCHC 32.90 g/dL 31.50 - 34.50
Red Cell Distribution Width (RDW) 13.60 % 11.60 - 14.00
Total Leukocyte Count (TLC) 4.20 thou/mm3 4.00 - 10.00
Differential Leucocyte Count (DLC)
Segmented Neutrophils 40.90 % 40.00 - 80.00
Lymphocytes 42.50 % 20.00 - 40.00
Monocytes 7.80 % 2.00 - 10.00
Eosinophils 7.70 % 1.00 - 6.00
Basophils 1.10 % <2.00
Absolute Leucocyte Count
Neutrophils 1.72 thou/mm3 2.00 - 7.00
Lymphocytes 1.79 thou/mm3 1.00 - 3.00
Monocytes 0.33 thou/mm3 0.20 - 1.00
Eosinophils 0.32 thou/mm3 0.02 - 0.50
Basophils 0.05 thou/mm3 0.02 - 0.10
Platelet Count 234 thou/mm3 150.00 - 410.00
Mean Platelet Volume 9.8 fL 6.5 - 12.0
D - Dimer, Quantitative
D - Dimer <150.00 ng/ml DDU <243
Helicobacter Pylori Antigen, Rapid Stool Test
Helicobacter Pylori Antigen Negative
Immunoglobulin IgE
Immunoglobulin IgE 233.00 kUA/L <64.00
Amylase, Serum
Amylase 92.00 U/L 30.00 - 118.00
Lipase, Serum
Lipase 32.00 U/L 12.00 - 53.00
Prolactin, Serum
Prolactin 8.59 ng/mL 2.10 - 17.70
PSA (Prostate Specific Antigen), Free, Serum
PSA, Free 0.212 ng/mL
Sex Hormone Binding Globulin (SHBG), Serum
SHBG 55.80 nmol/L 14.55 - 94.64
Allergy, Individual Marker, Candida Albicans, Serum
Candida Albicans 0.00 kUA/L <0.35
Electrolytes and Minerals
Calcium, Total 10.30 mg/dL 8.70 - 10.40
Phosphorus 3.90 mg/dL 2.40 - 5.10
Sodium 140.00 mEq/L 136.00 - 145.00
Potassium 4.82 mEq/L 3.50 - 5.10
Chloride 102.00 mEq/L 98.00 - 107.00
DHEA-S; Dehydroepiandrosterone Sulphate, Serum
DHEA Sulphate 182.90 µg/dL 139.70 - 484.40
Homocysteine, Quantitative, Serum
Homocysteine 8.17 µmol/L 3.70 - 13.90
Urine Examination Routine
Colour Light Yellow Pale yellow
Specific Gravity 1.015 1.001 - 1.030
pH 7.5 5.0 - 8.0
Proteins Negative Negative
Glucose Negative Negative
Ketones Negative Negative
Bilirubin Negative Negative
Urobilinogen Normal Normal
Blood Negative Negative
Leucocyte Esterase Negative Negative
Nitrite Negative Negative
R.B.C. Negative 0-2 RBC/hpf
Pus Cells Negative 0-5 WBC / hpf
Epithelial Cells 0-1 Epi Cells/hpf 0-5 Epi cells/hpf
Casts None seen None seen/Lpf
Crystals None seen None seen
Others None seen None seen
2

No. Your numbers look inline for your age. Would like to se LH and FSH but your test levels indicate there is prob no issue there as your balls are working.
I feel your situation is prob gut related rather than hormone. Maybe your not absorbing nutrients as well as you could be and your recovery is suffering?
What does your 83kg’s look like? Thats 183lbs so your not packing a ton of muscle for your height.
What do your WO’s/diet currently look like?

Expand

I’ve heard a bit about this but never really studied it. What are next steps? If Docs are not giving you clear direction here then they prob just don;t know where to go. I would do a ton of research here and possibly find a specialist to help. GP’s don’t really like to admit when something is beyond their knowledge. You def need to be your own advocate here.

If you did choose to try this route you would not start at 50mg/wk. That is prob gonna be too low and your levels may actually be lower than they are now once your balls shut down. Personally I would start 100mg-120mg and see where you are after a few months.

3

Hey Man,

Thanks for hearing out. Really appreciate it.

Diet currently stands at Proteins are eggs , chicken and occasionally fish/goat.

Veggies carrots most of days pre meal . Not much to add here, go low on veggies. Can tolerate more but probably don’t look much into it .

Carbs are Sourdough, white rice , sweet potatoes, potatoes ,dates and fruits.

Fats are avocados , coconut oil, ghee and olive oil.

I mix and match every meal usually just eggs and sourdough are morning meal with pomegranate and two dates to end. Rest all stays same just different preparation.

I’ve been 90 kgs too but herniated L4 , L5 and S1 so went off training which made me loose muscle and now shredded few to stay lean until not 100 percent recovered from back issue.

Been on bpc157 and tb500 from past 6 weeks planning to continue it for next 3 weeks more subq . Post that switching to oral bpc for next 3 months.

Hope this helps . Thanks

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I’ve been diagnosed with functional dyspepsia, literally in a bad day my upper abdomen is under fire and couldn’t handle much.

I’ve had few specialists of functional medicine help me too they somewhat educated me about elimination and reintroduction of food but haven’t solved it forever yet.

5

So it sounds like you have direction. How is this working?
Is this diagnosis from the functional med or from a specialst?

This ongoing or acute and now your repairing?
I had disc issues for 20+ years and ended up having PRP done around the spine musculature so it would support me instead of the disc supporting me and failing. That was prob 4-5 years ago and i havne’t had an issue since. Might be something to look at.

6

I kind off disagree with the diagnosis, it isn’t helping much . Was diagnosed by specialist. I work towards everything in my knowledge to keep flare ups at bay but having hard time.

Ahh man it sucks, really wish no one goes through it ever . Kudos to you for looking like that post injury :grinning_face:

Not acute repairing pretty well actually now , under a specialist rehab sports injury trainer .

7

Yeah i feel that is an “I don’t really know” diagnosis. Covers a lot of bases.
Get your CRP checked in your bloodwork. See how much inflammation we have going on.

8

Last got it tested in May2025 . HsCRP 0.74 mg/L

(below 3 seems to be doing fine according to lab). Hope this answers something, but soon will get checked again.

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9

Your T levels are not even close to being low brother. The symptoms that you’ve listed could be a plethora of things that testosterone is not likely to fix, especially considering the fact that yours isn’t too low to begin with. Your desired protocol will likely put you and even lower level levels than you are natural naturally as it begins to suppress you. Point being look for something else cause it’s not low T.

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Yes seems reasonable now , nothing seems to be working for gut thought this might help.

It definitely stops me from being jacked too which i want to be . More than absorption eating more is an issue.

anyways thank for the honest opinion man really appreciate it.

11

I would start the oral bpc sooner rather than later.

Is there anything now or in the past that could lend itself to either a dopamine or a serotonin interruption?

Your symptoms line up a bit along those two parameters.

Have you tried mitochondrial boosters?
Might help?

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Antibiotics use is the thing that seems the reason.

I hardly know what serotonin and dopamine disruptions do to body and how it works , sorry for being misinformed.

Waiting for bpc and kpv oral ordered already. No clue about mitochondrial boosters? Do let me know what do you suggest . I hardly work around AI tools and googe anymore , its better to get it first hand from experienced person. Bear with me :grinning_face:. Thanks

13

Ask to be tested for SIBO.

Look up:

Semax
Methylene Blue

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14

Just got tested last month. Negative . No sibo.

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15

I know that it doesn’t help your current gastric problems, but a negative result on this is huge long term.

16

Long term as in ? Sorry couldn’t get you.

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Sorry….meaning that SIBO is a difficult condition long term. Difficult to manage.

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But it came negative, GI maping shows no pathogen growth.

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That’s why I said being negative is huge as in a good thing.

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Ohh okay . Got it.