Testosterone Imposters: An Analysis of Popular Online Testosterone Boosting Supplements

Abstract

Introduction: Testosterone boosting supplements (T-Boosters) are prominently featured on Amazon.com with numerous dedicated pages and claims that they "naturally" increase testosterone levels. Aim: To evaluate the highest rated and frequently reviewed T-Boosters on Amazon.com to facilitate patient counseling regarding marketing myths, T-Booster formulations, and evidence for efficacy and safety. Methods: The Amazon marketplace was queried using the keywords "testosterone" + "booster" with default search settings and ranking items based on relevance. The top 5 T-Boosters identified on July 22, 2018 were reviewed based on price, ratings, reviews, manufacturer details, and ingredients. Consumer reviews were categorized using core themes in the Androgen Deficiency in the Aging Male (ADAM) questionnaire as a proxy to understand T-Booster efficacy and reanalyzed following filtration of untrustworthy comments using ReviewMeta.com, a proprietary Amazon customer review analysis software. Outcomes: Quantitative and qualitative evaluation of T-Boosters on Amazon.com. Results: The top 5 T-Boosters had an average ± SD of 2,761 ± 5,112 reviews and a rating of 4.56 ± 0.25 stars. Nineteen unique ingredients were identified across these T-Boosters, and literature review revealed 191 studies involving the 10 most common ingredients, of which 19% involved human subjects, 53% animal models, 15% in vitro studies and 12% case reports or review articles. Amongst 37 human studies, 30% observed an increase in T levels, 3% a decrease, 46% no effect, and 22% were indeterminate. Analysis of top customer reviews from the first two pages of reviews

Low Testosterone on Social Media: Application of Natural Language Processing to Understand Patients’ Perceptions of Hypogonadism and Its Treatment

“…TRT prescriptions have risen almost 4-fold over the last two decades, which can be attributed, in part, to off-label indications and direct-to-consumer advertising [ 25 ]. Even beyond standard TRT, testosterone-boosting supplements with minimal data to support their efficacy are aggressively marketed and readily available online [ 26 ]. But still, social media represents an enormous opportunity for the medical community to improve how we engage with our patients and to do so in a meaningful and impactful way.…”

Low Testosterone on Social Media: Application of Natural Language Processing to Understand Patients’ Perceptions of Hypogonadism and Its Treatment (Preprint)

“…TRT prescriptions have risen almost 4-fold over the last two decades, which can be attributed, in part, to off-label indications and direct-to-consumer advertising [25]. Even beyond standard TRT, testosterone-boosting supplements with minimal data to support their efficacy are aggressively marketed and readily available online [26]. But still, social media represents an enormous opportunity for the medical community to improve how we engage with our patients and to do so in a meaningful and impactful way.…”

Manipulation of Dietary Intake on Changes in Circulating Testosterone Concentrations

“…There appears to be an abundance of testosterone boosters that are marketed to the consumer. Balasubramanian and colleagues [63] recently examined the efficacy of the five top-ranked products and reported that the number of human studies conducted provided no definitive evidence for the efficacy of these products. Similarly, Clemesha and colleagues [64] reported that only ~25% of the 50 products they tested claiming to be testosterone boosters had scientific data to support their claims.…”