TRT side effects: what fitness TikTok gets wrong about the risks

What did @jav.iqbal.fitness2 actually say?

The creator claims he has been on TRT for 10 years and that his worst side effect has been "random bonus" (clearly meaning random erections). He acknowledges this is personal experience, not a universal outcome, and mentions he gets regular bloodwork done. He explicitly says he is not claiming others will be side-effect-free.

That caveat matters. He is not presenting this as medical advice or as evidence that TRT is risk-free. He is describing his own anecdotal experience while flagging that others may respond differently. That framing is more responsible than most of what circulates on TikTok in this category. But anecdotal reports, even well-intentioned ones, can still create misleading impressions about what TRT looks like across a population. The fact that his worst side effect was socially inconvenient but medically harmless does not reflect the full clinical picture.

Does the science back this up?

Partially. Some men on TRT do report relatively minor side effects, and increased libido and spontaneous erections are documented in the literature. But the claim that serious side effects are rare in his personal experience does not mean the risk profile of TRT is benign across the board.

A 2023 randomized controlled trial published in the New England Journal of Medicine (Lincoff et al., TRAVERSE trial) found that TRT in middle-aged and older men with hypogonadism was non-inferior to placebo for major cardiovascular events, which was reassuring. However, the trial also found significantly higher rates of atrial fibrillation, pulmonary embolism, and acute kidney injury in the testosterone group. Erythrocytosis (elevated red blood cell count) is one of the most consistently documented side effects of TRT, reported in roughly 20-30% of patients depending on formulation and dose, per a 2018 review by Bhatt et al. in Current Urology Reports. Testicular atrophy and suppression of natural testosterone production are also well-documented. The creator's clean 10-year run is plausible but not representative.

What did they get wrong (or right)?

He got the framing right. He did not claim TRT is safe for everyone, he did not recommend a dose, and he did not tell viewers to start therapy. That is a low bar, but plenty of TRT content on this platform clears it face-first.

What he got wrong, at least implicitly, is the impression created by leading with a decade of smooth sailing. Viewers who are curious about TRT will hear "10 years, worst side effect was embarrassing erections" and walk away with a skewed baseline expectation. The serious risks, including erythrocytosis, hematocrit elevation, sleep apnea exacerbation, infertility from suppressed spermatogenesis, and injection site reactions, go unmentioned. A 2020 systematic review by Corona et al. in the Journal of Sexual Medicine found that adverse event reporting in TRT studies is inconsistent and often underpowered, meaning real-world risk may be higher than trial data suggest. His positive personal outcome is real, but presenting it without that context does the audience a disservice.

What should you actually know?

If you are considering TRT, "this guy had a good 10 years" is not a risk assessment. Here is what the evidence actually supports.

• Erythrocytosis is the most common serious lab abnormality on TRT, affecting up to 30% of patients. It raises clotting risk if unmonitored. Regular bloodwork, which the creator mentions doing, is not optional.
• TRT suppresses the hypothalamic-pituitary-gonadal axis. This means your body stops producing its own testosterone and sperm production drops significantly. For men who want future fertility, this is a major consideration before starting.
• The TRAVERSE trial (Lincoff et al., 2023, NEJM) cleared TRT of major cardiac risk in symptomatic hypogonadal men, but found elevated rates of atrial fibrillation and pulmonary embolism. These are not trivial findings.
• Side effect profiles vary considerably by formulation. Injections tend to produce more erythrocytosis than gels. Pellets have different absorption dynamics. Comparing experiences across delivery methods is not straightforward.
• Legitimate TRT is prescribed and monitored by a licensed clinician. A fitness coach on WhatsApp is not that, regardless of how good their personal results look.