Doctor’s orders: When it comes to longevity, DIY is a don’t.
Peptides, GLP-1s and hormones have all become buzzy topics in the health and wellness world, with fans raving about personal transformations and biohacking wins.
But just because you can buy something easily online doesn’t mean you should. In fact, doctors find the do-it-yourself mentality particularly worrisome.
“The most troubling trend is men trying to do longevity medicine without a physician,” Dr. David Shusterman told The Post.
“They are ordering testosterone, peptides, erectile dysfunction medications, and GLP-1 weight-loss drugs online without a complete evaluation,” said Shusterman, a board-certified urologist and founder of UroLongevity and Modern Urologist.
Living well for longer is a booming movement, with some estimates putting the market at $33 trillion. While concierge medicine services offer high tech, physician-led health monitoring and optimizing, some people looking to get in on it cheaply and easily often take a DIY approach.
Shusterman said men are accessing all sorts of medications for things like sexual health and muscle building without a doctor’s oversight. In the gray market, the medications may be of dubious purity, and clients are deciding on dosing themselves.
That can be unhelpful at best — and downright dangerous at worst.
“I am very supportive of modern longevity medicine, but it has to be data-driven and medically supervised,” he said.
Shusterman’s approach is “not random biohacking. It is advanced diagnostics, hormone optimization when appropriate, metabolic and weight medicine, cardiovascular risk detection, sexual wellness, prostate and bladder health — and longitudinal follow-up.”
Here’s what people are getting into and why the DIY approach is more trouble than it’s worth.
Gray market of peptides
Peptides are building blocks of proteins that act as a kind of “key” to turn on biological processes like repairing damage and reducing inflammation. GLP-1s like Ozempic are peptides that regulate blood sugar and signal fullness to the brain.
For now, peptides are strictly regulated by the FDA, with only certain ones approved for a narrow purpose and require prescriptions.
That may soon change. Health Secretary Robert F. Kennedy Jr. and his agency are looking to ease restrictions allowing compounding pharmacies to produce a number of peptides, something usually reserved for when there’s medication shortages.
Meanwhile, peptides are still widely sold without a prescription. Companies sell peptides under the guise of being purely for “research” and not for human use. This allows them to bypass purity standards.
There’s also a number of peptides on the market that aren’t tested for human use, like the tissue repair peptide BPC-157, which some believe could accelerate tumor growth in patients with cancer.
Using a DIY approach to peptides introduces a host of issues. Without a doctor, people rely on advice from others online on which to use, how to dose, and how to use the peptide.
It’s all without professional oversight that would normally look out for interactions with other medications a patient might be on, or prior conditions they have. Plus, patients don’t support to deal with side effects or unintended consequences of the peptide.
Testosterone and sexual health medication
Testosterone therapy, or TRT, is a common treatment for men who have age-related drops in testosterone. It can help improve sex drive, boost performance, increase muscle, drop fat, and stabilize energy and mood.
But recently, a younger crowd has been accessing testosterone to get a chiseled look. In some online circles, issues like not developing muscle mass quickly enough or simply “not looking masculine enough” are getting pinned on low testosterone.
As a result, more people are looking to get on TRT and anabolic steroids, which are synthetic or modified testosterone.
In the US, the medication is tightly controlled and require a prescription to get ahold of. To get a prescription, blood tests are required to show testosterone levels are low, and that TRT is actually needed.
Yet one study showed only 12% of men who have a testosterone prescription actually had low testosterone levels.
Part of the reason is that it’s easier than ever to get. Online services offer mail-in tests and telemedicine visits with a doctor. An estimated 11 million are on the drug.
What bothers Schusterman, though, are those offering testosterone without a complete evaluation and longitudinal follow up. Without these, a patient could be putting themselves in a dangerous situation.
Testosterone could stimulate prostate growth and make existing cancer there worse, or stimulate too much red blood cell production, forming a clot that could be deadly.
Testosterone also carries risks to fertility by limiting your body’s natural production of testosterone. This can result in decreased sperm count and shrunken testicles. TRT could permanently affect the production of sperm.
Legitimate providers should require bloodwork and a real clinical consultation, as well as follow up monitoring and labs.
“Modern men’s health should be proactive, but it should not be reckless,” Shusterman said. “The future of men’s longevity is physician-led, diagnostic, and personalized.”
