The Endurance Stack: What Cyclists and Runners Add to TRT

Here's something you don't hear much at the local cycling club: a bunch of guys in their 40s and 50s casually discussing their hormone protocols between interval sessions. But spend enough time around serious endurance athletes, and you'll realize that testosterone replacement therapy has become about as common as discussing power meters and running shoes.

The thing is, TRT alone isn't the full picture for endurance athletes. Most of them aren't just taking testosterone and calling it a day. They're stacking it with other compounds and supplements specifically chosen to support long rides, marathon training blocks, and recovery from the kind of volume that would break most people.

So what exactly are they adding, and why?

The Red Blood Cell Conversation

Let's start with the elephant in the peloton: hematocrit management. When you're on TRT, your red blood cell production often increases. That sounds great for endurance performance, and it can be, but there's a ceiling. Push your hematocrit too high and your blood gets thick. That's not just a performance issue; it's a health risk.

Many endurance athletes on TRT donate blood regularly to keep levels in check. Some work with their doctors to dial in their testosterone dose to maintain optimal hematocrit levels around 50-52%. It's a balancing act that requires regular bloodwork and honest communication with your physician.

Cardarine: The Controversial Compound

Walk into certain cycling forums or ultrarunning groups, and you'll eventually hear whispers about GW501516, better known as Cardarine. Technically not a hormone, it's a PPAR delta agonist that was originally developed for metabolic disorders.

The appeal is obvious. Studies showed it dramatically increased endurance in mice. Some athletes report being able to push harder for longer with improved fat oxidation. But here's where it gets tricky: research was halted due to cancer concerns in animal studies, and it's banned by WADA. It's not FDA-approved for any use.

Despite this, it remains popular in certain circles. We're not here to recommend it, just acknowledge that it's part of the conversation when discussing what endurance athletes actually use.

The Recovery Stack

This is where things get more mainstream and medically sound. Serious endurance athletes on TRT often add:

BPC-157 and TB-500: These peptides have gained traction for injury recovery and tissue repair. When you're logging 200+ miles a week on the bike or running 70-mile weeks, nagging injuries are inevitable. Some athletes swear these peptides help them bounce back faster from overuse injuries.

HGH or Growth Hormone Peptides: Human growth hormone isn't just for bodybuilders. For endurance athletes, the appeal is recovery and tendon health. Some opt for actual HGH, while others use peptides like Ipamorelin or CJC-1295 to stimulate natural production. The costs vary wildly, and so do the results.

NAD+ and Injectable Vitamins: IV vitamin drips have become mainstream in endurance sports. Many athletes on TRT add regular NAD+ infusions, claiming improved energy and recovery. Whether it's placebo or physiological doesn't matter much if you feel better and train harder.

The Support Supplements

Beyond the injectables and peptides, most endurance athletes on TRT maintain a robust supplement protocol:

Cardiovascular Support: CoQ10, omega-3s, and magnesium are staples. When you're stressing your cardiovascular system with both hormones and high-volume training, heart health becomes paramount.

Joint Support: Glucosamine, chondroitin, and collagen peptides show up in nearly every endurance athlete's cabinet. Add in curcumin for inflammation, and you've got the basic joint protection stack.

Mitochondrial Support: Alpha-lipoic acid, PQQ, and additional CoQ10 for cellular energy production. Endurance performance ultimately comes down to mitochondrial efficiency.

The Dialing-In Process

What separates athletes who successfully combine TRT with endurance training from those who struggle? Bloodwork. Lots of it.

Successful endurance athletes on TRT typically monitor:

• Complete blood count (watching that hematocrit)

• Lipid panels (endurance exercise helps, but hormones can affect cholesterol)

• Liver and kidney function

• Thyroid hormones (often overlooked but crucial for endurance)

• Iron levels (especially if donating blood regularly)

• Inflammation markers

They're also honest about recovery. If you're on TRT thinking it'll let you recover faster and pile on more miles indefinitely, you're setting yourself up for injury. The athletes doing this successfully still respect rest days, deload weeks, and the signals their bodies send.

The Performance Reality Check

Does TRT improve endurance performance? The research is mixed, and the real-world reports vary. Some athletes report better recovery between sessions, improved body composition that helps with power-to-weight ratio, and more consistent energy. Others notice minimal performance changes but appreciate the quality of life improvements.

What's clear is that TRT alone won't make you faster. The endurance athletes seeing benefits are still putting in the work—the early morning rides, the long runs, the structured training. They're just potentially recovering better and maintaining muscle mass more easily while doing it.

The Medical Perspective

Any discussion about stacking compounds should come with a reality check: work with qualified medical professionals. The endurance athletes doing this right have doctors who understand both hormone optimization and the demands of endurance training. They're getting regular bloodwork, adjusting protocols based on data, and monitoring for side effects.

The DIY approach might work for a while, but endurance training already stresses your system. Adding hormones and other compounds without medical oversight is asking for trouble. At minimum, you need a doctor who's willing to order comprehensive bloodwork every few months and adjust your protocol based on the results.

Finding Your Protocol

If you're an endurance athlete considering TRT or already on it and wondering what else might help, start with the basics: dial in your testosterone dose, manage your hematocrit, and get your recovery fundamentals right. Sleep, nutrition, and stress management will do more for your performance than any exotic peptide.

From there, additional compounds should be added one at a time with clear goals and measurable outcomes. Don't stack everything at once and hope for the best. Work with your doctor, track your metrics, and be patient with the process.

The endurance athletes who successfully navigate TRT aren't the ones chasing every new compound. They're the ones who approach it methodically, respect the medical guidance, and remember that no hormone protocol replaces the fundamental work of training consistently and recovering intelligently.

Ready to explore TRT with medical professionals who understand the demands of endurance training? AlphaMD specializes in hormone optimization for active individuals, combining telemedicine convenience with physician expertise. Whether you're clocking miles on the bike or logging long runs, we'll help you find a protocol that supports your performance and health goals.