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In my opinion, its likely a little bit of both

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Most people experience some nausea, especially during dose increases, but it's often manageable

The findings from T Trials are complemented by results from two recent larger testosterone RCTs, Testosterone for the Prevention of Type 2 Diabetes Mellitus (T4DM) and Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE)

Common drug classes that can cause serotonin syndrome include selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and opioids like tramadol