Spotting Counterfeits
Why Counterfeits Are Dangerous
Counterfeit HRT medications pose serious risks:
- Under-dosed — no hormone effect (wasted money, delayed transition)
- Over-dosed — dangerous side effects (toxicity, blood clots, liver strain)
- Wrong substance — different medication than labelled (e.g., sugar pills, or worse — other active drugs)
- Contaminated — bacteria, heavy metals, toxins, fungal contamination
- Non-sterile injectables — risk of abscess, sepsis, or blood infection
Injectable Medications (Vials)
Visual Inspection Checklist
| Check | What Genuine Looks Like | ❌ Counterfeit Indicators |
|---|---|---|
| Solution clarity | Clear, no visible particles — colour varies by oil (MCT = clear, grapeseed = pale yellow, sesame = golden) | Cloudy, hazy, floating specks, fibres, crystals |
| Vial seal | Crimp cap is smooth, even, and intact | Loose, dented, or re-sealed cap; signs of tampering |
| Rubber septum | Clean, no visible wear before first use | Multiple puncture marks, discoloured, debris |
| Label quality | Professional printing, clear text, no smudging | Blurry text, misspellings, poor alignment, generic plain label |
| Batch/lot number | Clearly printed, alphanumeric, 6+ characters | Missing, handwritten, or appears on a sticker (not printed) |
| Expiry date | Present, legible, reasonable timeframe (2–3 years from mfg) | Missing, smudged, or > 3 years from manufacture date |
| Concentration | Clearly stated (e.g., "250 mg/mL") | Missing or ambiguous concentration |
| Carrier oil | Oil type listed | No oil specified |
| Manufacturer | Verifiable pharmaceutical company or known homebrewer | Unknown or fake manufacturer name |
The "Float Test" for Oil-Based Injectables
Drop a tiny amount of the oil into room-temperature water:
- Genuine: Oil should bead up and float (lower density than water)
- Suspicious: If it immediately disperses or sinks, it may not be oil-based
⚠️ This is NOT a definitive test — use blood tests or HPLC for verification.
Pills / Tablets
Visual Inspection Checklist
| Check | What Genuine Looks Like | ❌ Counterfeit Indicators |
|---|---|---|
| Shape and size | Consistent across all pills | Varied sizes, irregular shapes, chipped edges |
| Colour | Uniform shade throughout | Uneven colour, speckled, spots |
| Imprint code | Clearly stamped, matches known reference | Missing, blurry, incorrect code, or easy to scrape off |
| Score line | Clean break line (if applicable) | Off-centre, barely visible |
| Blister pack | Professional foil, consistent pocket sizes | Cheap-looking foil, inconsistent pockets, easy to tear |
| Packaging text | Clear, no errors | Misspellings, grammatical errors, poor print quality |
| Batch/lot number | On both blister pack AND outer box | Missing from either; mismatched numbers |
Common Imprint Codes for HRT Medications
| Medication | Common Imprint | Typical Appearance |
|---|---|---|
| Estradiol 2mg (Estrace) | "E 2" or "E2" | Blue, round, scored |
| Estradiol 2mg (Progynova) | "PG" or "2" | Blue-green, round |
| Spironolactone 25mg | "SP 25" or "25" | White, round, scored |
| Spironolactone 100mg | "SP 100" or "100" | White, round, scored |
| Cyproterone 50mg (Androcur) | "LA 50" or "50" | White, round, scored |
| Bicalutamide 50mg | "B 50" or "50" | White, round, film-coated |
Gel Packets / Sachets
| Check | What Genuine Looks Like | ❌ Counterfeit Indicators |
|---|---|---|
| Foil seal | Intact, properly heat-sealed | Torn, re-glued, leaking, easy to open and reseal |
| Gel consistency | Clear to slightly opaque, uniform gel | Watery, separated, discoloured, grainy |
| Labelling | Professional, with brand name, strength, batch, expiry | Poor quality print, missing info |
| Sachet material | Thick, high-quality foil | Thin, cheap-feeling foil |
| Manufacturer details | Present and traceable | Missing or fake manufacturer |
At-Home Testing Methods
Water Test (Pills) — ⚠️ NOT Reliable
Some people recommend dropping pills in water or vinegar to observe behaviour (e.g., sinking vs. floating, colour change). These tests are not scientifically validated and should NOT be used to determine authenticity.
Blood Test Verification — ✅ Most Reliable
The single most reliable way to verify your medication is to check your blood levels at a known dose:
| Medication | Expected Level at Standard Dose |
|---|---|
| Estradiol 4 mg/day (oral) | E2: 60–100 pg/mL (trough) |
| Estradiol 6 mg/day (oral) | E2: 100–200 pg/mL (trough) |
| Testosterone 100 mg/week (injectable) | Total T: 700–1,000 ng/dL (trough) |
| Spironolactone 100 mg/day | T levels should be suppressed (varies) |
| CPA 12.5 mg/day | T levels should be significantly suppressed |
If your levels are far below what the dose should produce, the medication may be under-dosed or counterfeit.
Third-Party Laboratory Testing (Gold Standard)
For absolute certainty, send a sample to a testing lab:
| Test | What It Measures | Typical Cost |
|---|---|---|
| HPLC | Exact concentration of active ingredient | $100–$200 |
| GC-MS | Full compound identification + quantification | $150–$300 |
| Sterility testing | Bacterial/endotoxin contamination | $50–$150 |
| FTIR | Quick identity check (is this the right substance?) | $50–$100 |
Community testing pools: Some Reddit communities organise group buys — multiple people contribute to test one batch, splitting the cost.
Batch Numbers and Authentication
What Legitimate Products Have
- Clear batch/lot number printed on the label
- Format: Alphanumeric, typically 6–12 characters (e.g., "B2401A", "LOT2401001")
- Machine-printed (not handwritten or stickered)
- Cross-reference: Some manufacturers have online verification portals
Red Flags
| Red Flag | Why |
|---|---|
| Batch number is handwritten | Unprofessional, untraceable |
| Batch number on a sticker (not printed) | Easy to fake and replace |
| No batch number at all | No traceability |
| Multiple products share same batch number | Each product run should have a unique batch |
| Expiry > 3 years from manufacture | Unrealistic for most medications |
Red Flags Summary
| ❌ Red Flag | Why It's a Problem |
|---|---|
| Price far below market average | Likely under-dosed or counterfeit |
| No photos of actual product (only stock images) | Seller may not have the product |
| Refuses to share batch info or testing | Hiding something |
| Packaging looks generic, no branding | Not from a legitimate manufacturer |
| Seller has many negative reviews in last 3 months | Trust community consensus |
| Pressures you to buy quickly | Prevents research; classic scam |
| Only accepts Western Union / MoneyGram | No buyer protection or recourse |
| Website looks unprofessional / full of errors | Likely a scam operation |
| Product looks different from community reference photos | Compare before using |
| Label has spelling mistakes (e.g., "Estradoil", "Testosteron") | Unprofessional; counterfeit indicator |
What to Do If You Receive Suspect Medication
- Do not use it — contaminated or incorrectly dosed medication can cause serious harm
- Take clear photos — of the product, label, packaging, and batch number
- Post to community forums — r/TransDIY, r/FTMDIY, or relevant Discord for verification
- Contact the seller — some legitimate sellers will replace or refund
- Warn the community — post a review to help others avoid the same issue
- If you already used it and feel unwell — seek medical attention immediately
- Dispose safely — do not flush; take to a pharmacy drug take-back program
References
- FDA. How to spot counterfeit medicine. https://www.fda.gov/drugs/buying-using-medicine-safely/counterfeit-medicine
- r/TransDIY Wiki. Verification and safety. https://www.reddit.com/r/TransDIY/wiki/index
- WHO. Substandard and falsified medical products. https://www.who.int/health-topics/substandard-and-falsified-medical-products
- Janoshik Analytical. HPLC testing services. https://janoshik.com/