It is legal to buy testosterone online, but only with a prescription. The DEA prescription guidelines require patients to have a validly diagnosed medical condition from a physician with whom they have a legitimate doctor/patient relationship (Clement et al., 2012). You should expect that U.S. online doctors prescribing testosterone will follow a protocol that requires a preliminary blood panel, a history and physical exam, and a discussion on the risks and benefits of using testosterone based on your lab values, medical history, and symptom profile. Unfortunately, this is not what you might find across the web. One study found that approximately half of all websites selling anabolic steroids advocated for their safe use, regardless of whether a medical condition was present. About one-third offered to sell them without a prescription (Clement et al. 2012).

Testosterone is a hormone, specifically an androgen. Hormones are produced by a gland or special neural tissue, travel through the blood, and affect receptors throughout the body. In addition, there is a strong interrelationship between the actions of the endocrine and the nervous systems. The bottom line is the expected cause-and-effect relationship between testosterone replacement therapy, and resolving your symptoms does not always occur.

Three million Americans may have used anabolic-androgenic steroids such as testosterone for non-medical purposes (Cohen et al., 2007). Using any medication should be carefully considered, and testosterone is not an exception. For many men, with documented low testosterone levels and symptoms that can be attributed to low testosterone levels, the benefits of testosterone replacement therapy far outweigh the risks. However, according to the DEA, these men are not the ones illegally obtaining testosterone and other anabolic-androgenic steroids (AAS) (Clement et al., 2012).

Testosterone As A Legal Prescription Medication

Testosterone was first synthesized in 1935. Shortly thereafter, there were reports that athletes injected it to improve their athletic performance (Nieschlag & Nieschlag, 2014). The U.S. government passed the Anabolic Steroids Control Act of 1990, which labeled testosterone as a schedule III controlled substance. It was not until 2003 that professional and Olympic athletes’ use of steroids became widely recognized (Coward et al., 2013).

Schedule III Drugs:

Substances in this schedule have a potential for abuse less than substances in Schedules I or II, and abuse may lead to moderate or low physical dependence or high psychological dependence.

Examples of Schedule III narcotics include products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with Codeine®), and buprenorphine (Suboxone®).

Examples of Schedule IIIN non-narcotics include: benzphetamine (Didrex®), phendimetrazine, ketamine, and anabolic steroids such as Depo®-Testosterone.

U.S. Department of Justice Drug Enforcement Administration

All schedule III drugs require a prescription from a doctor who has established a physician-patient relationship and has documented a direct connection between their medical findings and the need for testosterone replacement therapy. This U.S. based doctor may practice online and legally prescribe testosterone. When this doctor-patient relationship has been established, and a prescription is written, then it is legal to get started on Testosterone Replacement Therapy Online.

Illegal And Legal Places To Acquire Testosterone

Websites selling testosterone legally online in the U.S. require a prescription from a doctor. The pharmacy filling the prescription must also be located in the U.S. and licensed. Many pharmacies selling testosterone online do not require a prescription, are not located in the U.S., and therefore are selling testosterone illegally. Many of these online websites selling testosterone are operating out of countries such as Mexico and Thailand, in which AAS are available without a prescription (Clement et al., 2012).

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A Scientific Study Looking At Those Who Do Not Acquire Testosterone Legally

In one study, the authors found that injectable testosterone preparations and synthetic anabolic-androgenic steroids (AAS) are easily obtained on the internet without a prescription. Nearly all the websites they evaluated, regardless of the country of origin, accepted all common payment methods, obtained supplies from unregulated international pharmacies, and shipped their products directly to the consumer’s home address. They included a disclaimer that delegated legal responsibility to the consumer for complying with local laws governing consumption (McBride et al., 2018).

The thousands of internet websites selling AAS and other drugs without a prescription offer the disclaimer they are not endorsing the sale of AAS to individuals in countries in which it is illegal and perhaps even taking it a step further by stating that it is illegal for private individuals to import AAS into the U.S. So while it is legal to buy testosterone online, it is not legal to do so without a prescription (McBride et al., 2018).

Read Also: Testosterone Replacement Therapy Online Options

The U.S. Government Tests The Theory That You Can Get Testosterone Online Illegally

When the United States Government Accountability Office placed 22 orders for AAS on websites using a credit card, they received 14 shipments of which they found genuine AAS in ten shipments. All the packages were shipped in anonymous packages from pharmacies in Europe and Asia (Brennan et al., 2013). The United States Accountability office anticipated that the average user ordering testosterone online illegally would be in their late teens to 20s and active in organized sports. Cohen et al. (2007) questioned thousands of users, and this is what they found.

“The typical user was a Caucasian, highly educated, gainfully employed professional approximately 30 years of age, who was earning an above-average income, was not active in organized sports, and whose use was motivated by increases in skeletal muscle mass, strength, and physical attractiveness.”

(Cohen et al., 2007)

Risks Of Using Testosterone Inappropriately

Standards of care exist for making diagnoses, evaluating lab values, and prescribing medications so that a databank of information is available to all prescribing physicians. This databank of information, in the form of peer-reviewed papers, allows prescribers to learn from one another and for the medical field to progress to be safer and more effective.

If you choose to purchase testosterone without a prescription, you are taking many risks.

• Not knowing for sure it is a lack of testosterone causing your symptoms.
• A medical condition may worsen if it is not diagnosed early or if testosterone replacement is started when there is a contraindication.
• The chemical composition of the product you inject into your body may be unknown, or at least unregulated.
• The strength and the dosage of testosterone may be inaccurate.
• When you inject testosterone, your body will decrease production accordingly. If your dosage is incorrect and you stop injecting testosterone, it will take time for your body to resume production.
• Excess testosterone may be converted to estrogens leading to side effects such as gynecomastia.
• Without a proper lab work-up, you will not have a base-line hematocrit (red blood cells in the blood). Testosterone injection can increase red blood cell production, increasing the risk for a blood clot.
• Testosterone injection may adversely affect fertility.
• There is the potential for decreased testicular size because of suppression of the hypothalamic-pituitary-testicular hormonal axis.
• Abscesses or other skin infections may develop from using non-sterile preparations for injecting testosterone (Brennan et al., 2013).

Proper Diagnosis And Monitoring Is Essential

Proper monitoring of side effects and hormone levels is essential to ensure that you have the maximum benefits with minimum side-effects from your treatment. It is legal to buy testosterone online as long as the online pharmacy requires a prescription from a doctor located and licensed in the U.S.

Summary

Approximately 35% of sites offering to sell testosterone online are commercial sites, which sell AAS without a prescription. One study found that only a negligible number of pharmacies (<2%) were legitimate online pharmacies. Less than 5% offered unbiased information about the use or misuse of anabolic steroids, and 5-10 percent of sites focused on how to reduce harm from using anabolic steroids. The largest number of pharmacies were registered in Eurasia, Central Asia, or Middle Eastern countries. The majority of retail sites were registered in Slovenia or Austria. The greatest number of portal websites linking to these other sites were in the U.S. and Canada (Clement et al., 2012).

The large web portal sites in the U.S. have relationships with manufacturers in Mexico, Russia, Romania, and Greece. Selling anabolic steroids in these countries can be legal without a prescription. Since foreign distributors are not breaking laws in their countries, their government is not apt to cooperate with the U.S. government to crack-down on steroid imports. They can ship imported steroids in hollowed-out books and other disguises, making it very difficult to catch these imports given the millions of packages imported into the U.S. each day (Cramer et al., 2005).

In summary, yes, it is legal to buy testosterone online if you have a prescription from a local or online doctor who is licensed to prescribe testosterone in the U.S. Don’t stop there in your investigation on how to receive treatment for low testosterone safely. Ensure that your pharmacy is a U.S. based licensed pharmacy that complies with the regulations set by the F.D.A.

DISCLAIMER

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider.  You should always consult a practicing professional who can diagnose your specific case.  The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. 

References:

1. Coward R. M., Rajanahally S., Kovac J. R., Smith R. P., Pastuszak A. W., Lipshultz L. I. (2013). Anabolic steroid induced hypogonadism in young men. Journal of Urology, 190, 2200-2205. https://www.auajournals.org/doi/10.1016/j.juro.2013.06.010
2. Nieschlag E., Nieschlag S. (2014). Testosterone deficiency: A historical perspective. Asian Journal of Andrology, 16, 161-168. https://pubmed.ncbi.nlm.nih.gov/24435052/
3. Brennan B. P., Kanayama G., Pope H. G., Jr. (2013). Performance-enhancing drugs on the web: A growing public-health issue. American Journal on Addictions, 22, 158-161. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1521-0391.2013.00311.x
4. Clement, C. L., Marlowe, D. B., Patapis, N. S., Festinger, D. S., & Forman, R. F. (2012). Nonprescription steroids on the Internet. Substance use & misuse, 47(3), 329–341. https://doi.org/10.3109/10826084.2011.630225
5. Clement, C. L., Marlowe, D. B., Patapis, N. S., Festinger, D. S., & Forman, R. F. (2012). Nonprescription steroids on the Internet. Substance use & misuse, 47(3), 329–341. https://doi.org/10.3109/10826084.2011.630225
6. Cohen, J., Collins, R., Darkes, J., & Gwartney, D. (2007). A league of their own: demographics, motivations and patterns of use of 1,955 male adult non-medical anabolic steroid users in the United States. Journal of the International Society of Sports Nutrition, 4, 12. https://doi.org/10.1186/1550-2783-4-12
7. McBride, J. A., Carson, C. C., 3rd, & Coward, R. M. (2018). The Availability and Acquisition of Illicit Anabolic Androgenic Steroids and Testosterone Preparations on the Internet. American journal of men’s health, 12(5), 1352–1357. https://doi.org/10.1177/1557988316648704
8. Cramer R. J., Kaneshiro D., Rodriguez R., Egan R. (2005). Anabolic steroids are easily purchased without a prescription and present significant challenges to law enforcement officials (GAO-06-243R). Retrieved from http://www.gao.gov/new.items/d06243r.pdf

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