Since my thirty-second birthday, I’ve noticed myself slowing down. Hitting the big lifts at the gym requires more stretching and more recovery. The amount of caffeine I need to get through the workday would hospitalize a small child. Despite no discernible changes to my diet, I’ve been developing a paunch. A hard truth is that it now takes a tremendous amount of effort to maintain a slightly worse body than I had in my twenties.
Those feelings are compounded when I watch an influencer’s day-in-the-life video or read about some actor’s body transformation, like Zac Efron’s latest muscle gain. Looking like an Adonis always requires some variation on the same themes: A diet of protein and vegetables. Weight training six days a week. Cardio and good sleep. Following a similar program has left me looking like a moderately in-shape man. So is it all just a matter of age and genetics? Is there something I’m missing? In my unscientific research, the answer seems to be steroids.
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Because steroids are a controlled substance in North America, resulting in an active black market, the exact number of users is hard to pin down but studies point to more men experimenting with testosterone in recent years. What’s more remarkable is the growing number of blogs and videos where men openly talk about being juiced. Across YouTube, you can find thousands of testimonials attributing testosterone to improved physique, strength and mental health. It’s a promise that appeals to almost every part of my lizard brain.
According to pal Geoff Girvitz, host of The Dad Strength Podcast and owner of Bang Fitness, steroid curiosity is something he’s heard a lot from men of a certain age and disposition. “Working out and taking care of yourself can make big changes in your life,” said Girvitz, 47. “But a lot of guys turn to performance-enhancing drugs before they’ve even looked at fundamental things like diet, exercise and stress management.”
Steroids, he adds, aren’t something to take lightly because they cause substantial chemical changes in the body. Despite that, he understands why men are feeling the pressure to use. He says many of today’s bodybuilders, actors and professional athletes have created ideal male bodies based on performance-enhancing drugs. “I’ve known a number of people in various industries who have been on steroids long-term. The men who are serious about it are having regular blood work,” Girvitz explains. “They’re constantly checking in with their doctors and trainers. They have a whole team behind them to make it happen.”
The draw of steroids for me is about finding more energy and kick-starting big changes in how I look. But the way Girvitz described long-term users makes the decision seem more medical than recreational. As I researched more, that perception came up a lot. Some people are trying to make the case for steroids as medicine.
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The testosterone replacement therapy (TRT) market is expected to grow more than US$400-million globally between now and 2026. That’s in part due to an increasing number of startups specializing in hormone replacement therapy. Their selling point is that low testosterone and the accompanying symptoms are not an inevitability of time. They’re a sickness to be cured.
“When I turned 35 a few things started happening. My energy levels decreased. My focus and concentration went dramatically down. I put on weight around my midsection and my libido just completely went away. It made me question who I was as a man,” said Saad Alam, the CEO of Hone Health, an online clinic in North America offering specialized health plans for men. After running some tests, his physician said “there was nothing wrong with me. He thought it was all in my head. That’s when I started looking for specialists.”
Alam saw many doctors without finding results. Eventually, he was diagnosed with the testosterone levels of an 80-year-old man. Starting treatment was a watershed moment in his life. “I hate to sound kitschy, but it was like I could dream again … It gave me momentum back in my life,” Alam said. “Despite what stereotypes people have about testosterone, this is a chronic condition that is stealing parts of men’s lives. It doesn’t need to be that way.”
Testosterone levels must be medically low to qualify for treatment. In Canada, that means repeated total testosterone levels below 8.0 nmol/L for men under the age of 50 (normal levels are between 10 and 35 nmol/L). Before Hone distributes medication, patients undergo an assessment with a doctor and a blood test. If folks qualify, the company then charges a monthly subscription fee – which includes a quarterly online checkup with a physician – plus the cost of the prescriptions.
After chatting with Alam, my interest in steroids felt less like a dirty secret, and more like a medical condition. I wondered: Am I suffering a hormone imbalance, like so many others?
Despite some studies pointing toward low-testosterone levels afflicting up to a quarter of men over 30, not everyone is sold on the idea that it’s a rampant problem. Dr. Christopher Labos, an associate in the office of science and society at McGill University, believes that the rapid rise of testosterone prescriptions has more to do with marketing than sound medical care.
“Testosterone levels are going to decrease a little bit as we get older. Testosterone levels and most hormone levels can also fluctuate quite a bit from day to day. So if you do a blood test and the testosterone level is low, that doesn’t necessarily mean something,” said Dr. Labos. “The problem is that a lot of the people who have been diagnosed with low testosterone don’t have a validated medical diagnosis.” The result is people getting treated for a condition they don’t really have.
The cardiologist and epidemiologist also says selling testosterone as a miracle cure often overlooks the side effects. Men taking testosterone are at risk for infertility, shrinking testicles, hair loss and potential liver damage, among other things. Those risks are compounded when folks turn to black market sources and take the drugs without the aid of medical supervision, or get prescriptions, which can cost as much as $500 a month, from online health resources more concerned with their bottom line than their patients’ health.
“It’s not that testosterone treatment is wrong. There are people who have testosterone deficiency and need to be treated for it. It’s when you start marketing ads to people and not taking the proper time to assess their needs,” said Dr. Labos. “You’re telling them they’re sick when they aren’t. You’re making them spend money they don’t need to spend and you’re exposing them to side effects that you don’t necessarily need to expose them to.”
As for me, talking to Alam and Labos gave me two different perspectives to consider. For now, I’m waiting for blood work results to check my testosterone levels. If my numbers come back low, I’m not sure what I’m going to do yet. There are a few friends who have taken the plunge. They assure me that this decision should be personal and approved by a doctor. At the gym, I’ve noticed that they’re looking leaner. Last week I tried to keep up with their weights on the bench press and found myself falling short. It’s not that either of these things are a big deal, really. But I do find myself thinking, what if.
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