Testosterone use in children and adolescents carries significant risks and is only justified for well-defined medical conditions. While testosterone deficiency can impair pubertal development, hormone therapy must be initiated only after confirmed diagnosis by a pediatric endocrinologist. Administering testosterone without medical necessity – for performance enhancement or cosmetic reasons – is not only ineffective but dangerous. Potential risks include premature closure of growth plates, acne, mood swings, liver toxicity, and long-term effects on fertility. Long-term safety data in healthy adolescents are lacking. The evidence base is mixed: for approved indications like delayed puberty or hypogonadism, moderate to strong evidence supports therapy; for 'anti-aging' or 'biohacking' purposes in children, no credible studies exist. Parents should be wary of DNA tests claiming to predict 'testosterone needs' – such claims are scientifically unsupported. Instead, a balanced diet, adequate sleep, and regular physical activity remain the safest interventions for healthy development.
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