睾酮冒牌货：对热门在线睾酮增强补充剂的分析。
Testosterone Imposters: An Analysis of Popular Online Testosterone Boosting Supplements.
机构信息
Baylor College of Medicine, Houston, TX, USA.
Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA.
出版信息
J Sex Med. 2019 Feb;16(2):203-212. doi: 10.1016/j.jsxm.2018.12.008.
INTRODUCTION
Testosterone-boosting supplements (T-Boosters) are prominently featured on Amazon.com, with numerous dedicated pages and claims that they "naturally" increase testosterone levels.
AIM
To evaluate the highest rated and frequently reviewed T-Boosters on Amazon.com to facilitate patient counseling regarding marketing myths, T-Booster formulations, and evidence for efficacy and safety.
METHODS
The Amazon marketplace was queried using the key words "testosterone" + "booster," with default search settings and ranking items based on relevance. The top 5 T-Boosters identified on July 22, 2018, were reviewed based on price, ratings, reviews, manufacturer details, and ingredients. Consumer reviews were categorized using core themes in the Androgen Deficiency in the Aging Male (ADAM) questionnaire as a proxy to understand T-Booster efficacy and reanalyzed after filtration of untrustworthy comments using ReviewMeta.com, a proprietary Amazon customer review analysis software.
MAIN OUTCOME MEASURES
Quantitative and qualitative evaluation of T-Boosters on Amazon.com was performed.
RESULTS
The top 5 T-Boosters had an average ± SD of 2,761 ± 5,112 reviews and a rating of 4.56 ± 0.25 stars. 19 unique ingredients were identified across these T-Boosters, and literature review revealed 191 studies involving the 10 most common ingredients, of which 19% involved human subjects, 53% animal models, 15% in vitro studies, and 12% case reports or review articles. Among 37 human studies, 30% observed an increase in T levels, 3% a decrease, 46% no effect, and 22% were indeterminate. Analysis of top customer reviews from the first 2 pages of reviews for each supplement revealed differences in the ADAM score before and after ReviewMeta.com filtration. After filtration, there was a 91% decrease in users reporting increased libido, a 59% decrease in reports of increased energy, a 93% decrease in reports of improved strength/endurance, a 60% decrease in reports of improved erections, an elimination of reports of improved work performance, a 67% decrease in reports of improved sleep, and an 89% decrease in reports of improved sports ability.
CLINICAL IMPLICATIONS
Our study can serve as a guide for providers to counsel patients about the efficacy of popular online T-Boosters as well as the prevalence of disingenuous reviews associated with these products on online marketplaces like Amazon.com.
STRENGTHS & LIMITATIONS: Strengths include the novel approach to assess consumers' perceptions and satisfaction of T-Boosters, as well as summary information that clinicians can provide patients. Limitations include selection bias, a small number of supplements analyzed, and the proprietary nature of the Amazon review analysis software.
CONCLUSION
T-Boosters are easily available online. Our investigation revealed that limited human studies have evaluated T-Boosters, resulting in no definitive findings of efficacy. In the absence of additional human studies, patients should be cautioned before considering T-Boosters, given the availability of highly effective therapies approved by the Food and Drug Administration. Balasubramanian A, Thirumavalavan N, Srivatsav A, et al. Testosterone Imposters: An Analysis of Popular Online Testosterone Boosting Supplements. J Sex Med 2019;16:203-212.
简介
睾酮增强补充剂（T-Boosters）在亚马逊网站上备受瞩目，有许多专门的页面和声称它们“自然”地提高睾酮水平。
目的
评估亚马逊网站上评价最高和评价最多的 T-Boosters，以便为患者提供关于营销神话、T-Booster 配方以及有效性和安全性证据的咨询。
方法
使用“睾酮”+“助推器”等关键词在亚马逊市场上进行查询，使用默认搜索设置并根据相关性对项目进行排名。2018 年 7 月 22 日确定的前 5 种 T-Boosters 是根据价格、评级、评价、制造商详细信息和成分进行评估的。使用雄激素缺乏症在老年男性（ADAM）问卷中的核心主题对消费者评价进行分类，作为了解 T-Booster 疗效的代理，并在使用亚马逊客户评价分析软件 ReviewMeta.com 过滤不可信评论后重新分析。
主要观察指标
对亚马逊网站上的 T-Boosters 进行定量和定性评估。
结果
前 5 种 T-Boosters 的平均评论数±标准差为 2761±5112 条，评分为 4.56±0.25 星。这些 T-Boosters 中发现了 19 种独特的成分，文献综述显示涉及 10 种最常见成分的研究有 191 项，其中 19%涉及人体研究，53%为动物模型，15%为体外研究，12%为病例报告或综述文章。在 37 项人体研究中，30%观察到睾酮水平升高，3%降低，46%无影响，22%不确定。对每个补充剂的前 2 页的顶级客户评价进行分析，揭示了经过 ReviewMeta.com 过滤前后 ADAM 评分的差异。过滤后，用户报告性欲增加的比例下降了 91%，报告精力增加的比例下降了 59%，报告力量/耐力增强的比例下降了 93%，报告勃起改善的比例下降了 60%，报告工作表现改善的比例下降了 100%，报告睡眠改善的比例下降了 67%，报告运动能力改善的比例下降了 89%。
临床意义
我们的研究可以为提供者提供指导，让他们了解在线流行 T-Boosters 的疗效，以及与亚马逊等在线市场上这些产品相关的虚假评价的普遍性。
优势与局限性
优势包括评估消费者对 T-Boosters 的看法和满意度的新颖方法，以及临床医生可以为患者提供的总结信息。局限性包括选择偏差、分析的补充剂数量较少以及亚马逊评论分析软件的专属性。
结论
T-Boosters 在网上很容易买到。我们的调查显示，有限的人体研究评估了 T-Boosters，因此没有发现明确的疗效。在没有更多人体研究的情况下，应告诫患者在考虑使用 T-Boosters 之前要谨慎，因为有经食品和药物管理局批准的非常有效的治疗方法。Balasubramanian A、 Thirumavalavan N、Srivatsav A 等。睾酮冒牌货：对流行在线睾酮增强补充剂的分析。J 性医学 2019；16：203-212。
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