Doctors inundated by testosterone requests fuelled by online misinformation

By Emma Wilkinson

Doctors have warned that social media misinformation and marketing around low testosterone is putting additional pressure on NHS services.

Endocrinologists and GPs say they are being inundated by men asking about low testosterone levels or who have been started on treatment privately that they may not need.

A wave of companies are marketing blood tests to check for testosterone levels if men are feeling fatigued or have a reduced sex drive.

Speaking with Doctors.net.uk, Professor Channa Jayasena clinical professor in reproductive endocrinology and andrology at Imperial College London said it was already a “very big problem”.

As chair of the Society for Endocrinology Andrology Network, he says they have had education meetings where it is all clinicians want to talk about because of the growing numbers of men in their clinics who have incorrectly been told they need testosterone.

“Every single clinic in the country is seeing this.” Men are having tests through private providers who then also sell them medications for £100 a month and then because of the expense turn to the NHS to help, he adds.

“They are understandably very confused and upset when they get, from their perspective, conflicting information.”

He has been doing a content analysis study into the misinformation prevalent online, not just in the UK he adds.

“You can see there are systemic and widespread inaccuracies with information, both in diagnosis, but also the symptoms people experience, but also the effects and the appropriateness of starting testosterone.”

You see men across age ranges from those in their 20s and 30s who feel they lack muscle growth and can feel very low about it, to men in their 40s and 50s who have always been athletic but have noticed a reduction in physical performance to those in their 60s and 70s who are seeking help for sexual function, he explains.

Often there are other reasons for their symptoms or testosterone levels including not being as healthy as they once were, he says.

“It needs careful, objective assessment to see how convincing the symptoms are, how low the testosterone is, and counsel them about the about whether testosterone is the right thing.”

It can be very hard to unpick the disinformation and it puts pressure on waiting lists for everyone else, he says.

Risks of treatment

Taking testosterone unnecessarily can suppress the body’s natural hormone production, cause infertility, and increase the risk of blood clots, heart problems and mood disorders, he continues.

A large study a couple of years ago which ruled out cardiovascular risk for men taking testosterone was in men with clinically low testosterone levels not this wider group that are now being marketed to, he adds.

“They say that 30% of all men who are middle aged and older have a low testosterone. That is true, but only 2% have a syndrome or have actual testosterone deficiency, almost all of those men are happily going about their business. So, it is completely wrong and inaccurate.”

Dr Selvaseelan Selvarajah, a GP in East London said: “We are certainly getting many young men asking us to check testosterone levels and wanting to track the levels in the future even if it’s normal.

“There is a perception testosterone replacement will give improved energy levels and endurance.”

Professor Azeem Majeed, a GP and professor of primary care and public health at Imperial College London said the message that true testosterone deficiency is relatively uncommon and usually linked to specific medical conditions is not getting across.

He added it is difficult to quantify the scale of testosterone use among young men because much of the prescribing occurs through private clinics or via illegal suppliers.

“For most men, symptoms such as fatigue or low mood are far more likely to be related to lifestyle factors, stress, or other health conditions rather than low testosterone.

 “GPs are therefore spending time explaining when testing is appropriate and why unnecessary testosterone therapy can do more harm than good.

“This is another example of how online marketing can create demand for medical tests and treatments that are not always clinically indicated, adding to NHS pressures and potentially diverting attention from the underlying causes of people’s symptoms.”

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