Misinformation on social media is driving men to NHS clinics seeking testosterone therapy they don't need, adding pressure to already stretched waiting lists, doctors say.
Testosterone replacement therapy (TRT) is a prescription-only treatment recommended by national guidelines for men with clinically proven deficiency, confirmed by symptoms and repeated blood tests.
But a wave of viral videos on TikTok and Instagram have begun promoting blood tests as a means of accessing testosterone as a lifestyle supplement, touting the hormone as a solution to problems such as low energy levels, poor concentration and decreased sex drive.
Doctors warn that 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.
The online demand for treatment is so great that healthcare providers have now started to see it reflected in their clinics.
Professor Channa Jayasena of Imperial College London, who chairs the Society of Endocrinology and Andrology Network, says hospital experts are seeing a rise in the number of men who have had private blood tests, often advertised on social media, who have been incorrectly told they need testosterone.
“At a national meeting we surveyed 300 endocrinologists across the UK; everyone sees patients from these clinics every week,” he said. “They're filling up our clinics. We used to see people with adrenal problems and diabetes and it's really affecting National Health Service care. We are all asking how to deal with this.”
Advertising prescription drugs is illegal in the UK, but the Guardian has discovered that a number of TikTok influencers are working with private medical clinics to promote blood tests, which are legal to advertise, as a route to testosterone therapy.
Advocates of testosterone replacement therapy, who have thousands of followers, are being paid or offered incentives by private clinics to promote discount codes and free gifts, encouraging men to get their testosterone levels checked and potentially access treatment.
In one post, a man does bicep curls and says: “Take a testosterone test… DM me for £20 off.” Another video offers a free blood test as part of a giveaway, telling men it will help them “take control” of their activities.
The Guardian flagged the posts to the Advertising Standards Authority for potential regulatory breaches because they advertised prescription drugs, prompting the watchdog to investigate.
Jayasena said: “I have just returned from the national training course for Next Generation Endocrinology Consultants and most people have expressed concern about reproduction and this issue: a barrage of men being pushed to increase their testosterone levels.”
He added: “Influencers aside, this is a huge problem. Hospital specialists are seeing patients come in after having private blood tests, often arranged perhaps through influencers, and then being told by inexperienced doctors or a wide range of medical professionals that they should start taking testosterone. The advice they are giving is wrong.”
Private clinics charge between £1,800 and £2,200 for the first year of TRT. Packages include medications, monitoring and counseling.
TRT was once a niche medical treatment for a small number of men with clinically diagnosed hormonal deficiencies, but is now increasingly being redefined as a lifestyle or “performance optimization” tool. Online clinics offer at-home blood tests and subscription packages, making it easier to access outside of traditional healthcare systems.
Social media posts often suggest that low motivation, fatigue or aging are signs of “low testosterone,” leading more men to seek testing and treatment, even though medical guidelines limit TRT to only those with a proven hormonal deficiency.
Jayasena said: “There are specific clinical recommendations about who should and should not start taking testosterone. Certain symptoms, such as erectile dysfunction, are clearly associated with low testosterone. Other symptoms, such as lack of muscle mass or feelings of depression, are not associated with low testosterone. A man may say, 'I'm not very muscular' and be advised to get tested, but there is no evidence that he needs it.”
“The most worrying thing is that these clinics are starting testosterone for men with normal testosterone levels. There is no evidence that testosterone levels above 12 nmol/L are beneficial, and I have heard of clinics starting testosterone for men under 18 years of age, which includes the majority of the population.”
He added that taking the drug unnecessarily can cause infertility. “It suppresses testicular and brain hormonal signals needed for testicular function, so clinics prescribe a mixture of other drugs to stop this phenomenon, the same approach that anabolic steroid users take.”
TikTok has been approached for comment.
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