Underwriting & the Rise of TRT, HGH, and Supplements

In the past few years, one of the fastest-growing underwriting trends we’ve seen isn’t around traditional conditions like diabetes or heart health—it’s around testosterone replacement therapy (TRT), human growth hormone (HGH), and supplement use. These treatments and lifestyle aids are becoming more mainstream, and with that comes more frequent questions from advisors and clients alike: How do they affect life insurance underwriting?

I recently sat down with our Chief Underwriter, Ken Turscak, to break this down. Here are the key takeaways from our conversation.

Testosterone Replacement Therapy (TRT)

TRT has exploded in popularity over the last 3–5 years, especially among men in their 40s and 50s. From an underwriting perspective, Ken made one thing very clear:

• Prescription is key. If TRT is physician-prescribed and monitored, coverage is typically favorable. In fact, clients can often still qualify for preferred or even preferred best rates.
• Gym locker purchases = declines. If the source isn’t legitimate—like “a guy in the back of the gym”—the case will be declined outright.

Bottom line: If it’s coming from the pharmacy with doctor oversight, underwriting is comfortable. If not, it’s a non-starter.

HGH (Human Growth Hormone)

As clients age, HGH has become a popular anti-aging tool. However, carriers treat it differently than TRT:

• Case-by-case review. Unlike TRT, HGH use is underwritten with more caution.
• Best outcome: Standard rates. Preferred classes are almost never available, but standard is often possible depending on records and lab results.
• Why the difference? There are more risks and potential side effects tied to HGH compared to testosterone, so carriers scrutinize these cases more closely.

Supplement Use: Where’s the Line?

Supplements are everywhere—from vitamins and herbal remedies to performance boosters for athletes and weekend warriors. Ken highlighted a few important distinctions:

• Anabolic steroids = automatic decline. Even if they’re technically available over the counter, they’re a non-starter in underwriting.
• Everyday supplements are fine—unless they skew labs. Things like vitamins, natural remedies for anxiety or prostate health, or endurance gels for athletes are usually okay. The concern is less about the use itself and more about potential side effects or abnormal labs they might cause.

Tips for Advisors: How to Pre-Underwrite These Cases

When you come across a client who uses TRT, HGH, or is a heavy supplement user, here are some questions and practices that can help:

• Ask why they’re on the therapy. Is it medically necessary, performance-driven, or for anti-aging?
• Confirm they’re being monitored. Regular physician follow-ups make all the difference.
• Watch for side effects. Any history of abnormal labs or complications should be addressed upfront.
• Gather documentation. APS records, recent labs, and even a cover letter explaining usage can help avoid underwriting surprises.

Ken summed it up perfectly: “Whenever you know there may be a question mark in the underwriter’s mind, anything and everything you can provide upfront is always a good practice.”

The Bigger Trend

The use of TRT, HGH, and supplements is no longer niche. More clients are turning away from prescription medications in favor of these therapies and natural remedies. For advisors, that means one thing:

Always ask the blanket question: “Are you taking any supplements, hormone therapies, or similar treatments?” Even if it’s not on the application, it can absolutely affect underwriting outcomes.

Final Thought

Our role is to anticipate these emerging trends and prepare advisors for how they’ll impact coverage. Whether it’s TRT, HGH, or supplements, the good news is that—with the right documentation—coverage is often still favorable.

At Cavalier, we’re here to help you navigate these underwriting nuances so you can protect your clients with confidence.