Testosterone or steroids alongside

Testosterone, steroids and 'peptides' come up in gym talk. No judgment here: what matters is that your doctor knows. First, the signs that need care.

When to get care

• Now

  If a skin infection where you inject comes with fever, chills, a racing heart, dizziness or confusion, call emergency services now.

• Today

  If the skin where you inject turns red, hot, swollen and painful, and it's spreading, get care today.

  These can be signs of infection, which is more likely with products that may not be sterile.

• Now

  If your skin or the whites of your eyes turn yellow, or your pee turns dark, get emergency care now.

  Liver injury has been reported in Australia with products sold as retatrutide, which isn't approved anywhere.

• Soon

  If you use, or are thinking about using, testosterone, anabolic steroids or 'peptides' alongside this medicine, tell your doctor in the next few days.

  No judgment, just safety. Products without registration can have a different dose and purity than the label says.

• Soon

  If your medicine came without a prescription, from the internet, social media or abroad, or says 'research use only', tell your doctor or pharmacist in the next few days.

  No one has checked what's inside. Bring your log from the app.

What's known

In men with obesity and low testosterone, testosterone tends to go up as weight comes down, and European guidelines put weight loss first. Studies with these medicines found a small rise, tied to the weight lost. In men whose testosterone wasn't low, a controlled study saw no change.

Testosterone therapy pushes levels higher, but it lowers the hormones LH and FSH, and in small studies sperm counts fell. Guidelines advise against starting it if you plan to have kids soon, and ask for regular checks of testosterone and red blood cells (hematocrit).

The labels of these medicines don't mention testosterone, and there's little research on using both together.

Products bought without a prescription are another story. 'Research use only' on a label doesn't make a product safe for people, and tests of products sold online found from half to almost twice what the label says, plus contamination.

What usually helps

• Telling your doctor what you use
• Keeping your log in the app, to bring to the appointment

To take to your appointment

• I use testosterone prescribed by another doctor. Does that change anything in my treatment or my tests?
• I'm thinking about testosterone or other products from the gym. Can we talk about it first?