The ‘T’ illusion

Strap: The craze for boosting testosterone is sweeping online, luring teenage boys into dangerous hormone use and misinformation

Blurb:

Extreme self-improvement and optimisation trends spread like wildfire online. They tap into common anxieties about masculinity, status and popularity. Conflating “manliness” with testosterone levels and a muscular physical appearance exploits an insecurity ripe for marketing.

Videos promoting #testosteronemaxxing are racking up millions of views. Like “looksmaxxing” or “fibremaxxing” this trend takes something related to body image (improving your looks) or health (eating a lot of fibre) and pushes it to extreme levels.

Testosterone or “T” maxxing encourages young men – mostly teenage boys – to increase their testosterone levels, either naturally (for example, through diet) or by taking synthetic hormones.

Podcasters popular among young men, such as Joe Rogan and Andrew Huberman, enthusiastically promote it as a way to fight ageing, enhance performance or build strength.

However, taking testosterone when there’s no medical need has serious health risks. And the trend plays into the insecurities of young men and developing boys who want to be considered masculine and strong. This can leave them vulnerable to exploitation – and seriously affect their health.

What is testosterone?

We all produce the sex hormone testosterone, but levels are naturally much higher in males. It’s produced mainly in the testes, and in much smaller amounts in the ovaries and adrenal glands.

Testosterone’s effects on the body are wide ranging, including helping you grow and repair muscle and bone, produce red blood cells and stabilise mood and libido.

During male puberty, testosterone production increases 30-fold and drives changes such as a deeper voice, developing facial hair and increasing muscle mass and sperm production. It’s normal for testosterone levels to change across your lifetime, and even to fluctuate daily (usually at their highest in the morning).

Lifestyle factors such as diet, sleep and stress can also affect how much testosterone you produce.

Natural testosterone levels generally peak in early adulthood, around the mid-twenties. They then start to progressively decline with age.

A doctor can check hormone levels with a blood test. For males, healthy testosterone levels usually range between about 450 and 600 ng/dL (nanograms per decilitre of blood serum). Low testosterone is generally below 300 ng/dL.

Diagnosing low testosterone

In Australia, taking testosterone is only legal with a doctor’s prescription and ongoing supervision. The only way to diagnose low testosterone is via a blood test.

Testosterone may be prescribed to men diagnosed with hypogonadism, meaning the testes don’t produce enough testosterone.

This condition can lead to:

• Reduced muscle mass
• Increased body fat
• Lower bone density (increasing the risk of fracture)
• Low libido
• Erectile dysfunction
• Fatigue
• Depression
• Anaemia
• Difficulty concentrating
• Hypogonadism has even been linked to early death in men.

A manufactured panic about ‘low T’

Hypogonadism affects around one in 200 men, although estimates vary. It is more common among older men and those with diabetes or obesity.

Yet on social media, “low T” is being framed as an epidemic among young men. Influencers warn them to look for signs, such as not developing muscle mass or strength as quickly as hoped – or simply not looking “masculine”.

Extreme self-improvement and optimisation trends spread like wildfire online. They tap into common anxieties about masculinity, status and popularity.

Conflating “manliness” with testosterone levels and a muscular physical appearance exploits an insecurity ripe for marketing.

This has fuelled a market surge for “solutions” including private clinics offering “testosterone optimisation” packages, supplements claiming to increase testosterone levels and influencers on social media promoting extreme exercise and diet programmes.

There is evidence some people are undergoing testosterone replacement therapy, even when they don’t have clinically low levels of testosterone.

 

What are the risks of testosterone replacement?

Taking testosterone as a medication can suppress the body’s own production, by shutting down the hypothalamic-pituitary-gonadal axis, which controls testosterone and sperm production.

While testosterone production can recover after you stop taking testosterone, this can be slow and is not guaranteed, particularly after long-term or unsupervised use. This means some men may feel a significant difference when they stop taking testosterone.

Testosterone therapy can also lead to side effects for some people, including acne and skin conditions, balding, reduced fertility and a high red blood cell count. It can also interact with some medications.

So there are added risks from using testosterone without a prescription and appropriate supervision.

On the black market, testosterone is sold in gyms, or online via encrypted messaging apps. These products can be contaminated, counterfeit or incorrectly dosed.

People taking these drugs without medical supervision face potential infection, organ damage, or even death, since contaminated or counterfeit products have been linked to toxic metal poisoning, heart attacks, strokes and fatal organ failure.

 

Harm reduction is key

T maxxing offers young men an enticing image: raise your testosterone, be more manly. But for healthy young men without hypogonadism, the best ways to regulate hormones and development are healthy lifestyle choices. This includes sleeping and eating well and staying active.

To fight misinformation and empower men to make informed choices, we need to meet them where they are. This means recognising their drive for self-improvement without judgement while helping them understand the real risks of non-medical hormone use.

We also need to acknowledge that young men chasing T maxxing often mask deeper issues, such as body image anxiety, social pressure or mental health issues. Young men often delay seeking help until they have a medical emergency. If you’re worried about your testosterone levels, speak to your doctor.

***From The Conversation through Creative Commons