TikTok content on low testosterone lacks information on future risks, study finds

Findings from a recent analysis presented at the 2024 Annual Fall Scientific Meeting of the Sexual Medicine Society of North America (SMSNA) in Scottsdale, Arizona suggest that patients with symptomatic hypogonadism (“low T”) are turning to TikTok, a popular video-based social media platform, for information related to testosterone replacement therapy (TRT).¹

Only 1 of the 22 unique creators was a physician.

However, the analysis showed that many of these videos fail to discuss the negative long-term impact of these treatments.

The authors explained, “Patients are increasingly turning towards non-medical institutions for low T information and supplementation. By the time patients seek medical care, it may be due to improperly advised negative side effects.”

For the study, the investigators wrote a custom program to interface with the TikTok’s research application program interface (API). They searched for the most viewed TRT-related content via associated hashtags such as #trt, #lowt, and #testosterone. Videos were eligible for inclusion if they were in English, had text/verbal content, and were related to the subject matter.

The video content was then assessed by 2 independent reviewers, who graded the videos based on the American Urological Association’s (AUA) Testosterone Deficiency Guidelines (TDG) Counseling Regarding Treatment section.

Between October 2022 to October 2023, the investigators identified 562 videos. Of those, 50 videos created by 22 unique accounts met the criteria for inclusion in the study. Combined, these videos had more than 15 million views, nearly 1 million likes, and 35,000 shares.

A majority of included videos (72%; n = 36) were created by companies to advertise their proprietary supplements. The most common ingredients in these supplements were shilajit, tongkat ali, and ashwagandha root.

Only 1 of the 22 unique creators was a physician, who was trained in family medicine and was advertising his low testosterone screening service based on his personal experience with hypogonadism.

Among all videos, 36% mentioned that TRT may improve erectile function, lean body mass, and/or depressive symptoms, which is referenced in AUA-TDG14. However, only 4 videos flagged that there is inconclusive evidence on the ability of TRT to improve cognitive function, mentioned in AUA-TDG15, or encouraged lifestyle modification as a treatment strategy prior to TRT, referenced in AUA-TDG21.

Further, none of the videos mentioned the long-term impact of exogenous testosterone on spermatogenesis for those interested in future fertility, which is highlighted in AUA-TDG16.

Based on these findings, the authors indicated a need for more accurate and non-commercialized content created by physicians.

They concluded, “Patients turn to non-medical resources for low T information and supplementation, but these videos rarely discuss negative side effects. Given the lack of educational, non-commercial videos about TRT benefits and risks on popular content platforms like TikTok, we urge physicians to actively engage in creating accurate and holistic content to reach patients currently consuming health care disinformation.”

Reference

1. Cheng LG, Huang SL, Hwang K. TikTok for low T: Testosterone replacement therapy misinformation and supplementation on a popular video platform. Presented at: 2024 Sexual Medicine Society of North America Fall Scientific Meeting. October 17-20, 2024. Scottsdale, Arizona. Poster 209