From the magazine

Jeffrey Epstein couldn’t get control of his testosterone

Charles Cornish-Dale
 Getty Images
EXPLORE THE ISSUE March 2 2026

Jeffrey Epstein was a sick man. That’s hardly news. But a new dimension has been added to our understanding of him by the latest batch of files released by the Department of Justice. Physically, not just mentally and morally, Jeffrey Epstein was very, very unwell. For the better part of a decade, despite having billions of dollars and access to some of the world’s greatest practitioners of medicine, Epstein’s health only got worse. We can now follow his physical decline in depth – via emails and text messages, magazine clippings, scientific reports and website articles he saved – which is exactly what a number of internet sleuths have been doing.

On July 25, 2016, Epstein wrote to one of his long-term doctors, Bruce Moskowitz, and laid out everything that was wrong with his body at the time. “Bruce. lets summarize. angioedema. belly pattern, brain fog. sinus swollen. apnea – lumbar stenosis 1415, greatly reduced urine stream. – low libido bladder ultrasound negative, blood tests – low testosterone, high triglycerides. all cultures neg. semen urine. two cahill parasites positive, whipworm and hisiliyita. medicines to date – medrol. claritin, zantac. magnesium supplement for constipation. can’t figure it out. tawari found little, but suggested mri prostate, as no downside. cystoscope. possible stricture from years ago. made it too uncomfortable in office. lets talk.”

Epstein was suffering, variously, from abdominal swelling, excess belly fat, brain fog, breathing problems, a crooked spine, difficulties urinating, low sex drive, low testosterone, metabolic issues, two parasitic infections, constipation and an enlarged prostate. He was taking a number of different medications and being put through a regular battery of tests. He had blood drawn at least 20 times between 2010 and 2018.

One of the most enduring problems he faced was low testosterone. This seems odd for a man whose entire existence revolved around sex – having it himself and getting it for other powerful men (and maybe women), too. We now know Epstein was using Viagra. Lots of it. Testosterone is the master male hormone, responsible not just for aggression but also mood and motivation, including the desire to reproduce. A man with low testosterone is usually a man who doesn’t want to do anything, let alone have sex. And Epstein’s testosterone was low. At times, he had the testosterone levels of a post-menopausal woman. No joke. At their lowest, in 2016, they measured just 65 ng/dL. Generally, 300 ng/dL is considered low, at any age past puberty.

Between 2010 and 2018 – between the ages of 57 and 65 – Epstein never measured higher than 185. What was wrong with him? Androgen abuse – the use of exogenous hormones – is one possibility. In a deposition from last year, Epstein’s accomplice Ghislaine Maxwell said he had started taking testosterone in the mid-1990s. She said it “altered his character” and made him “aggressive” and “mean.” Epstein may have decided to “hop on gear” to make himself look and feel better as he approached his forties. That’s not unusual. Men’s testosterone levels generally start to decline by 1 percent year on year after the age of 30.

Managed in the right way, the use of exogenous testosterone shouldn’t cause irreparable damage to the testicles, but perhaps Epstein was just unlucky or given bad advice. On multiple occasions, his doctors suggested testosterone replacement, but he appears to have resisted, perhaps because he didn’t want to experiment with the treatment that had caused the problem in the first place. He wanted to try clomiphene instead, which can restart natural production.

Or maybe there was something else. A congenital defect, perhaps, that prevented his testicles producing adequate testosterone? During a deposition in 2009, Epstein was asked, to his amusement, if he had an “egg-shaped penis.” Other testimony suggests some kind of deformity, possibly a micropenis. We may never know.

Epstein tried just about everything to sort out his testosterone. By 2018, he may even have been drinking raw eggs, an old bodybuilding trick I know something about. A man named Gregory Brown forwarded him an article by Dr. Joseph Mercola about the benefits of cholesterol-rich animal-food diets and raw eggs in particular – contra 70 years of mainstream nutritional science. In 2011, one of Epstein’s doctors had suggested he should go on a vegan diet. Epstein found out: some things money can’t buy.

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