RFK Jr.’s Testosterone Regimen Is Almost Reasonable

Robert F. Kennedy Jr.’s personal health-care routine is perplexing in its inconsistencies. He decries seed oils, despite near scientific consensus that they’re harmless; drinks raw milk, which has been proved to get people sick; and takes testosterone as part of his anti-aging routine while insisting he’s not on anabolic steroids.

Some of his routines, such as downing raw milk for its purported health benefits, are based on bunk science. But his anti-aging protocol seems to be serving him well, even if its most obvious effects look a lot like juicing. While many men in their 70s are focused on staving off broken hips, Kennedy’s use of testosterone—which, despite his protestations to the contrary, is in fact a steroid—means he can crank out a set of pull-ups with ease.

What RFK Jr. does with his own body isn’t anyone else’s business. But his wellness routine is instructive in understanding how he views health-care regulation and self-experimentation. RFK Jr., should he be confirmed as secretary of Health and Human Services, will be America’s self-experimenter in chief. And taking testosterone is his most noticeable experiment.

Testosterone is best known for its role in puberty and in promoting traditionally male characteristics such as muscle mass and facial hair, but it affects countless other bodily functions. Men who don’t have enough testosterone to power these processes might be diagnosed with what’s often called hypogonadism, or low T. Some have testicles that are malfunctioning in testosterone production, while others see a decline in the hormone because of age. Regardless of the underlying cause, the deficit causes the body to function less efficiently.

But the condition can be treated with a relatively simple prescription of testosterone injections or gel, and research shows the impact can improve some of the symptoms of hypogonadism. One large clinical trial found that hypogonadal men on testosterone saw “modest but significantly greater improvements in mood and energy” compared with placebo. Researchers also found that older men with low T and mobility issues saw their ability to walk improve after supplementation, and that testosterone improved bone density.

Although doctors seem to be in agreement about treating men who have an actual problem with their testes, the question of whether to treat men who see their testosterone drop as they age has divided the medical community. There’s no clear reason an aging man with withering testosterone levels would not respond just as positively to testosterone as a man with testicular issues would, but critics argue that for aging men, the benefits are typically modest and can come with downsides. For example, Steven Nissen, a cardiologist who has been involved in testosterone research, has published a paper showing that testosterone supplementation was associated with an increase in bone fractures. The hormone, he told me, “should not be used as a fountain of youth.” The FDA, too, says that testosterone shouldn’t be prescribed to aging men experiencing natural decline, because the “benefits and safety of this use have not been established.”

Kennedy’s use of the hormone as what he calls an “anti-aging protocol” counts as an experiment, given the FDA’s stance. And he is far from the only man in this experiment. Anti-aging clinics ready to provide testosterone prescriptions to men they deem qualified have become ubiquitous online. The company Blokes warns on its website that “men will naturally decline testosterone levels due to aging.” Another, TRT Nation, promises “affordable medications for LOW TESTOSTERONE and Anti-Aging remotely and delivered to your door!”

Every doctor I spoke with was emphatic that only men with low testosterone levels should be on the drug. The long-term side effects of what’s called “hypersupplementation” are largely unknown, and some evidence suggests that benefits are limited when a man is already in the normal testosterone range, Landon Trost, who helped write the testosterone-treatment guidelines for the American Urological Association, told me. Many doctors are also understandably cautious about prescribing the drug to people who don’t have an actual medical condition, because it’s been abused for decades by athletes and healthy men looking to improve their physique. Advertising from telehealth companies, along with data showing that a sizable portion of men who get testosterone don’t even get their levels checked beforehand, lends credence to their fears. “Right now, it’s very much Wild West, buyer beware,” Trost said.

Should Kennedy be confirmed to lead HHS, his interest in testosterone could push the conversation about this hormone to more solid ground. He could, for example, encourage the National Institutes of Health, which he would oversee, to fund additional trials into the hormone’s potential use in aging men; work with the surgeon general to create a public-service campaign that both urges older men to get their testosterone levels checked and warns young people about the risks of abusing the drug; encourage drug makers to conduct more clinical trials; and and even advocate for the drug to be removed from the controlled-substances list, where it has been since 1990, when Congress hastily added it in response to doping scandals and over the objections of the American Medical Association, and where it is now classified as being as dangerous as ketamine.

Some of these actions would likely be applauded even by doctors who take a more conservative approach toward testosterone therapy. But the would-be health secretary has yet to signal any interest in bringing testosterone into the fold of modern medicine.

Kennedy seems attracted to certain wellness products precisely because they don’t have regulators’ stamp of approval. He has not spoken directly about the FDA’s regulation of testosterone, but he has said he wants to end the FDA’s “war on public health” by deregulating “psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins … [and] nutraceuticals.”

The amount of evidence supporting these different therapies and their relative risks varies wildly; what connects them is the FDA’s insistence that people should not self-experiment with them. And should Kennedy succeed in ending what he calls the agency’s “aggressive suppression” of his favored compounds, some Americans could die (using chelating compounds or stem cells, for instance, can be dangerous); others will needlessly throw their money and hope behind treatments that might be marketed as healthy but are no more effective than sugar pills. The FDA was created more than a century ago for the exact purpose of helping Americans avoid these types of problems. By calling for looser oversight of these compounds, RFK Jr. is signaling that patients should no longer trust the FDA’s judgments of what is safe. Instead, the logic follows, they should self-experiment—just like him.

Kennedy might have reasons for finding regulators’ historically conservative approach toward wellness products grating: His anti-aging protocol seems to be working so well that he looks as or more jacked at 70 years old than he did nearly three decades ago. If you got in the best shape of your life with the help of testosterone against regulators’ advice, you might be skeptical of them too.

The best-case scenario, if the country follows RFK Jr.’s lead, will be that self-experimentation pushes forward in some form the science behind these treatments. But each person who forgoes medical care for self-experimentation is one less data point that helps us as a society decide where we have therapies that work, and where we still need more research. That lack of data leaves everyone, except those willing to risk their own health on either their own hunches or those of wellness influencers, worse off. If Kennedy truly believes that these products can make America healthy again, he should channel his experience with self-experimentation into thoughtful regulatory policy. Testosterone could be his first target. With a little faith in the regulatory system he’s been so intent on trashing, he could help the many people who depend on the government to work out these questions. And ultimately, he might convince more of them that some of his favorite experiments stand up to scrutiny.