TRT and growth hormone myths: what the evidence actually says

What did @drterrysimpson actually say?

Dr. Terry Simpson calls out someone, apparently Liver King or a close associate, for framing steroid use as simply "TRT and growth hormone." He argues this language is deliberately deceptive, and he goes further, accusing Carnivore MD of selling supplements falsely marketed as containing "bioactive testosterone." His bottom line: if you think you have low testosterone, see a board-certified endocrinologist and skip the supplements.

The video is short and punchy, and it reads like a frustration that built up over time. Simpson's core message is consumer protection, not a clinical lecture. He's essentially saying two things: the framing of steroid use as "TRT" can mislead the public, and supplement brands exploiting testosterone anxiety are running a scam. Both points deserve a real look.

Does the science back this up?

On the TRT-versus-steroids framing issue, Simpson is largely correct. Supraphysiologic testosterone use, meaning doses that push levels well above the normal male range of roughly 300 to 1,000 ng/dL, is pharmacologically different from replacement therapy used to treat clinical hypogonadism. Calling the former "TRT" is misleading by definition.

The American Urological Association and the Endocrine Society both define TRT as therapy aimed at restoring testosterone to normal physiologic levels in men diagnosed with hypogonadism, confirmed by at least two morning serum testosterone measurements (Bhasin et al., 2010, Journal of Clinical Endocrinology and Metabolism). Using the term to describe performance-enhancing dosing obscures that distinction.

On the supplement claim, no over-the-counter supplement legally sold in the United States can contain testosterone. The FDA classifies testosterone as a Schedule III controlled substance. Any product marketed as containing "bioactive testosterone" is either making a false claim or is an illegal product. Period. The Federal Trade Commission has repeatedly warned against testosterone supplement marketing that implies hormonal activity without evidence (FTC, 2014, Deceptive Advertising Guidance).

What did they get wrong (or right)?

Simpson gets the core consumer protection argument right. But the video has a few gaps worth noting.

First, the phrase "do you think he looks like he needs to take that" is doing a lot of work. Physical appearance is a genuinely poor diagnostic standard for hypogonadism. Plenty of muscular men have clinically low testosterone, and plenty of men who look average have supraphysiologic levels. Diagnosis requires bloodwork, not a visual assessment. Simpson is a physician and should know this better than to lean on aesthetics as evidence.

Second, while his advice to see a board-certified endocrinologist is sound, it skips over real access issues. Endocrinologist wait times in the United States average 30 to 60 days in many markets, and not every patient has insurance coverage for hormonal workups. The advice is correct but incomplete.

Third, growth hormone is mentioned only briefly. GH use carries its own clinical and legal context that deserves more than a passing reference, particularly because off-label GH prescribing is a growing and genuinely complex issue (Liu et al., 2007, Annals of Internal Medicine).

What should you actually know?

If you are worried about low testosterone, the path forward is straightforward: get a blood test. The Endocrine Society recommends testing serum total testosterone in the morning, on at least two separate occasions, before any diagnosis or treatment decision is made.

No supplement legally sold without a prescription contains active testosterone. Products that claim to "support" testosterone levels typically contain zinc, vitamin D, or herbal ingredients like ashwagandha. Some of these have modest evidence behind them. None are equivalent to, or a substitute for, actual testosterone therapy when therapy is clinically indicated.

If TRT is genuinely warranted, the conversation belongs with a qualified clinician, ideally someone who can also rule out secondary causes of low testosterone like pituitary dysfunction, sleep apnea, or medication interactions. Self-diagnosing based on influencer content and purchasing supplements in response is a money sink at best and a health risk at worst.

Simpson is right to push back on the semantic game of calling steroid use "TRT." Language shapes how people understand risk, and when that language is used to sell supplements or protect a public persona, consumers lose.