Medical tests are marketed on social media as a way to empower people to take control of their health, but experts are warning to be wary of the harms influencers don’t mention.
Three controversial tests – full-body magnetic resonance imaging (MRI) scans, blood tests for testosterone levels and the Anti-Mullerian hormone (AMH) or “egg-timer” test, which surveys a woman’s egg count – are the focus of a campaign backed by the University of Sydney based on its own research trying to combat misinformation online.
All three tests carry the risk of over-diagnosis, leading healthy people to seek out interventions they may not have ever needed, says Dr Brooke Nickel, a senior research fellow at the Sydney Health Literacy Lab – the team behind the initiative.
The people spruiking these tests would have you believe information is power – but what’s being left out of the narrative getting spun on social media?
Is a full-body MRI necessary?
Kim Kardashian and Paris Hilton are among those to have spruiked this scan, encouraging people to do it in the name of early detection of disease, particularly cancer. Internationally, wellness and longevity clinics are “popping up every day” which market the scan (which can cost upwards of $800) to healthy people as a “holistic whole body check”, Nickel says.
However, leading medical bodies, including the Royal Australian and New Zealand College of Radiologists, have specifically recommended against doing it because there is no evidence of significant improvements in health outcomes for healthy people.
Instead, there is the risk in people who don’t have any symptoms that the test can pick up “incidental findings”, Nickel says. In a condition like cancer, this can mean catching very early forms of disease that are unlikely to cause any symptoms or problems in the long term but knowledge of which can do more harm than good, leading to anxiety and unnecessary treatments including radiotherapy and major surgery.
What is an AMH test, and what are the risks?
“The AMH test is being marketed as a test of women’s fertility when it actually can’t tell a healthy woman what their chances are of conceiving or what their reproductive timeline is,” Nickel says. The test can be useful in IVF treatment in women who have signs of infertility, but research has shown it is not a reliable sign of fertility in the general population.
The harms of women taking the test are primarily psychological, Nickel says, as it “preys on the vulnerability of women” of reproductive age and can lead to a false sense of time frames. “It can be pretty detrimental to be told you may not have enough eggs left and you need to speed up your reproductive timeline, or otherwise that they’re fine when in reality there might be other underlying issues.”
It can also lead to downstream implications, such as undergoing the expensive process of elective egg-freezing or having IVF when it may not be warranted, Nickel says.
Why are testosterone tests harmful?
Testosterone tests are often marketed to men as a way to check whether they have an “optimal” level of the hormone, Nickel says. The test is potentially harmful because it is closely linked to the promotion of testosterone supplementation, which can lead to negative side effects, she says.
In healthy men who don’t need it, the supplement carries a risk of blood clotting and impairing fertility , and there is also evidence for potential links to heart conditions.
How are people getting access?
Many medicines are prohibited from being advertised in Australia, but Nickel says social media is “like the wild, wild west” and influencers and companies are finding loopholes.
This creates an environment where companies can bypass the traditional need for a health professional to prescribe a test because they deem it medically necessary and instead market them direct to consumer, Nickel says.
The full-body MRI scans are often linked to the increasing number of wellness clinics, while the AMH test can often be delivered to a person’s home with the click of a button, with the results then mailed back to a clinic. That business model can be consequential, Nickel says, because it often leaves the onus on the consumer to interpret their results, without necessarily having a doctor to talk through what they might mean. “[In] some of the posts we saw, there were young women reading the results, thinking they’re completely infertile.”
The testosterone test is often conducted through wellness and longevity clinics; there are over-the-counter testosterone booster products but to access the clinical-grade supplement men are turning to hidden-market avenues, Nickel says.
Marketing to the worried well
Disease prevention is incredibly important, Nickel says, “but prevention really comes down to eating well, exercising, sleeping well, having healthy relationships and looking out for signs and symptoms of disease, and going and speaking to a doctor when that’s necessary”.
“But when the marketing is so persuasive and pervasive that it feels like the onus is on us as an individual to have to go and get these tests and be on top of our own health, it is really creating a population of the worried well.”
The campaign will release videos weekly on the university’s Facebook, Instagram and YouTube pages over the next month, as well as partnering with peak medical colleges to provide evidence-based information about these tests.
