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Are you tired? Feeling flat and irritable? Finding it difficult to concentrate? Maybe you’re experiencing the seemingly ubiquitous symptoms of modern life. Or, if you’re a man, you may have been told by countless uncredentialed online influencers that you’re probably suffering from “low T”.
For decades, testosterone has been marketed to men as a means to maximise virility. But in recent years, social media has fuelled the “T-maxxing” trend, in which men are encouraged to maximise their testosterone levels through either natural or artificial means.
Low testosterone is being blamed in the rightwing manosphere for a crisis of masculinity; global search interest in the term is up 60% from last year.
Popular podcasters such as Joe Rogan and Andrew Huberman openly talk about taking testosterone, as has the 72-year-old Robert F Kennedy Jr, who has said he uses testosterone replacement therapy as part of an “anti-ageing protocol”.
Elsewhere in the Trump administration, the US defense secretary, Pete Hegseth, announced in July that soldiers 30 and over would be tested annually to ensure they have the “right testosterone levels”.
Social media is awash with testimonies from men on testosterone replacement therapy who say they have lost weight and regained energy, motivation and libido. Prescriptions for testosterone in the UK and US have risen sharply in recent years.
But the fixation on T-maxxing ignores hard evidence: very few men actually have clinically low levels of the sex hormone, and taking exogenous testosterone – through injections or gels – comes with serious and potentially irreversible health risks, especially when treatment is unwarranted.
‘Fearmongering’ in the manosphere
Testosterone is a steroid hormone we all produce, but is naturally found at higher levels in men.
Testosterone levels fluctuate throughout the lifetime, says Prof Ada Cheung, an endocrinologist at the University of Melbourne.
Population-based studies show that testosterone rises rapidly during male puberty and that over time, “it does tend to decline a bit with age”, she says. “That decline with age we think is largely attributed to the accumulation of chronic health conditions as we get older” – conditions such as obesity, diabetes, high cholesterol and blood pressure. “But it doesn’t mean that every older man needs testosterone [treatment], because that’s not the case at all.”
Testosterone levels also vary through the day and in response to physical stressors such as illness and poor sleep. “It’s always low in the afternoon and highest first thing in the morning,” Cheung says. “Testosterone naturally varies when we eat … and if we’re sick in any way.”
Research suggests that average testosterone levels in men have declined over the last five decades, though they remain within normal reference ranges. Experts, Cheung included, believe the trend may be at least partly explained by lifestyle habits, stress, chronic disease and rising obesity.
Clinically low testosterone – also known as male hypogonadism – is “actually pretty uncommon”, Cheung says. “Less than 2% [of men] would have clinical hypogonadism.” It can can be caused by genetic conditions such as Klinefelter syndrome, or conditions that affect the pituitary gland in the brain, which regulates sex hormone production.
“Why people often get confused is that the symptoms of low testosterone are very non-specific, like fatigue, low mood, poor concentration, erectile dysfunction, low motivation,” Cheung says. Far more commonly, she points out, these issues are caused by other factors, such as stress, depression, obesity, and iron or thyroid issues.
But these symptoms are frequently used to promote testosterone screening and treatments on social media, says Dr Brooke Nickel, a senior research fellow at the University of Sydney’s school of public health.
Research she co-authored, published in January in the journal Social Science & Medicine, found that young men are being aggressively marketed to by testosterone influencers and wellness companies. Their analysis of 46 popular posts – from accounts with a total following of 6.8 million and which had amassed a combined 659,000 likes – found that nearly three-quarters of accounts had vested financial interests, such as being the sellers of testosterone tests and therapies.
“The narratives that they were discussing were closely mirrored to those promoted within the manosphere, where hormone levels were being presented as a measure of manhood,” she says.
Testosterone tests, they found, were primarily targeting younger men – a group for which mass screening for low testosterone is medically unwarranted. None of the posts, unsurprisingly, presented any evidence to support claims made.
Nickel describes such posts as “fearmongering” – using common experiences to suggest “there’s something medically wrong and that testosterone is a solution”.
What are the health risks of taking testosterone?
“Once you start testosterone and you are on it for a while, it’s very hard to wean. It’s not just a short-term thing,” Cheung says. Taking testosterone shuts off the body’s natural production of the hormone, as well as sperm production.
The American “looksmaxxer” Braden Peters, also known as Clavicular, is by his own admission infertile from steroid abuse.
“People can become infertile and it can take months to years to recover – and the recovery is not always guaranteed, which is probably one of the most serious concerns,” Cheung says.
Doctors have reported people taking testosterone presenting with gynaecomastia, (male breast enlargement), severe atrophy of the testicles, and early heart disease. Testosterone replacement therapy also increases the risk of blood clots.
For patients who do have clinical hypogonadism, “it’s often a lifelong commitment when we start treating someone with testosterone therapy”, Cheung says. “It can lead to things like sleep apnoea, acne, prostate issues, urinary difficulties, mood and libido fluctuations, so it’s not without risk.”
Men frustrated by barriers like financial costs and stigma when seeking out testosterone through regulated medical channels have reported getting the hormone through underground sources with relative ease, Australian research has found.
That poses its own health risks: Australian testing of anabolic steroids obtained from underground markets has found traces of carcinogenic heavy metals such as lead, arsenic and cadmium, as well as product mislabelling.
If men are concerned about symptoms and believe low testosterone may be an issue, they should contact a health practitioner, Cheung says. “If you’re worried, go and see your GP and have a conversation, rather than listening to someone trying to tell you something on social media.”
Donna Lu is an assistant editor, climate, environment and science at Guardian Australia. Antiviral is a fortnightly column that interrogates the evidence behind the health headlines and factchecks popular wellness claims
