There are some questions about the modern obsession with “low T,” or low testosterone, as replacement therapies have exploded in popularity. PsyPost noticed a case report in The Primary Care Companion for CNS Disorders about a man who, after a year of injectable testosterone, started hallucinating voices coming from his own body parts.

A 45-year-old man in India had spent 15 years dealing with infertility and had unknowingly been living with a genetic condition called Klinefelter syndrome, in which men have an extra X chromosome. The condition can cause low testosterone, infertility, osteoporosis, and reduced testicle size. This made him a perfect candidate for testosterone injections. And then things got really weird.

After about a year of monthly testosterone injections, the man started feeling paranoid. He developed grandiose religious beliefs. He barely slept. He started hearing voices, including the voice of God and voices that seemed to emanate from his own body. His neighbors picked up on it first and let his family know something was definitely wrong.

This Extremely Rare Testosterone Side Effect Left a Man Hearing Voices

Doctors halted the testosterone treatment and immediately switched him to antipsychotic meds. Within days, his symptoms improved and completely disappeared over the following two months. With everything seeming fine, the doctors put him back on testosterone, this time at a lower dose with psychiatric monitoring.

His limbs stopped talking to him. He was back to normal.

Being able to hold a conversation with your elbows isn’t something that’s going to happen to anyone receiving testosterone injections. It’s an extremely rare case involving a rare genetic condition that made this one guy particularly vulnerable, as injectable testosterone can cause some big hormonal peaks and valleys that can affect brain chemistry.

Hormones are not some magical masculinity juice. They are powerful biological chemicals that can potentially interact with your body in ways that are quite frightening, but usually aren’t. Testosterone has increasingly been marketed as a way to optimize aging men, to let them regain some of the vitality of their youth.

On the rarest of occasions, that might come with a side of talking limbs.