AIM-TEST: Microbiome-Targeted Nutrition for Functional Secondary Hypogonadism

AIM-TEST is a randomized, double-blind, placebo-controlled clinical trial evaluating whether an AI-guided, microbiome-targeted nutritional intervention can increase the body's own testosterone production in men aged 30-65 years with symptomatic, biochemically confirmed functional secondary hypogonadism. Functional secondary hypogonadism is characterized by symptoms of testosterone deficiency together with repeatedly low morning testosterone levels and low or inappropriately normal gonadotropin levels, without evidence of primary testicular failure or an organic hypothalamic or pituitary disorder. Men may be included regardless of their body weight or obesity status, provided that their low testosterone has been appropriately confirmed and does not require urgent disease-specific or hormonal treatment. Participants will be randomly assigned to receive either the active nutritional supplement or a matched placebo once daily for 12 weeks. The main question is whether the active intervention produces a greater increase in morning total testosterone than placebo. The study will also assess calculated free testosterone, symptoms of androgen deficiency, sexual function, metabolic and inflammatory markers, gut microbiome changes, treatment tolerability, and safety. Participants will be followed for an additional 12 weeks after stopping the study product to explore whether any observed effects are maintained. The study hypothesis is that the microbiome-targeted intervention will result in a greater improvement in endogenous testosterone levels than placebo. This is a proof-of-concept study and is not intended to replace standard diagnostic evaluation or established treatment when these are clinically required.