That is a fantastic insight, and a wild natural T level, especially with the low muscle gain! (As you inferred I measured at 650ng/dL with sample size 1; not sure how it flows with time; didn't get a free-test measurement, but should do that; kind of curious how that plays into your situation too) I was expecting to measure low based on the muscle thing + generally low-superficial-T features like minimal facial hair, and low body hair/thin eyebrows, then would have gone straight to it, but... I paused to reconsider after the measurement.

Doctors don't take stuff like this seriously (Varies wildly, but I have a number of family/friends who are doctors, and was in a military field under flight doc supervision/physicals for most of my career). I imagine it's not on their list of medically significant conditions as it's a superficial one. They deal with things that cause immediate or future health problems (or med disqualification for the job), or effect quality-of-life directly. Being extremely skinny (High or normal test for us respectively!) doesn't register as it's superficial/aesthetic. I wonder if your hormone-related identification would be more actionable as you have that number? While 6'2 / 130lbs (Not sure your example) is extremely rare, without any direct consequences on health, it doesn't register. Nothing to fail me on a physical for, no treatment plans that fit, and doesn't pattern match with people checking into hospital.

I think re growing the stomach - I meant more that responds very quickly to changes in diet in either direction; I can go from pudgy/belly to flat abs in a few weeks. I'm hoping the ab work will help a bit with overall look in well-fitting clothes or shirtless, and help with rib flare, but it's probably skippable compared to the bigger lifts.

For the macros, you're right: I have not being doing any tracking. I have been (For the past 6 months when I did a big shift) eating slowly, and paying attention to hunger/satiation signals. No longer finishing a meal just because it tastes good, if I'm no longer hungry. I have cut out all carbs-sans-fiber. No sugary foods (other than fruit, dark chocolate etc), no refined grains unless eating out. Lots of veggies, meat, eggs, and fruit + whey shakes. So, high protein, high fiber, normalish carbs and fat. As you say, probably need to load on the protein more. (More meat/whey/eggs/peanut butter?) How has the tracking worked out for you; any insights? I'm curious about the effort involved, and accuracy of any numbers put in.

I should do the dex! I'm curious; just looked up; $130 near me; will do it! The 12% estimate was based on visual cues like bicep vein, muscle definition, appearance of facial bones/masceters etc. If I eat lazily, it goes up to probably 18-20%; then I look like I have never seen a gym. Would love to see the actual number.

What is stopping you from doing the steroids now? Test or a mix? Worried about the hairline / body hair or negative face shape changes? I am giving this one final push, then will probably hop in in 1-2 years if this still isn't working. My lifts have stayed the same or gone slightly up while I've been getting lean. The lean thing for is a realization that I am accepting the build, and don't want to hide the muscles I have. I love the way I look without a shirt or in tight-fitting clothes now, but still have an extreme BMI.

Btw, that last point seems to be also one of those counter-intuitive things: For the ultra-skinny (Or maybe more acurrately for anyone who's lean, but has some muscles), looking good without a shirt or in form-fitting clothes is a completely different beast from not. Can go from "Looks fit" to "Doesn't know what a gym" is from a change of clothes alone!