Heath misinformation is rampant on Tik Tok, Chicago researchers find

Along with dance challenges, memes and an abundance of Taylor Swift fan theories, TikTok has become the home of another type of content: health information. But after conducting a study this year, two University of Chicago researchers are warning of misinformation making its way around the app.

In January, Dr. Christopher Roxbury and rising fourth-year medical student Rose Dimitroyannis analyzed 221 videos posted on sinusitis, or sinus infections, on the app over a 24-hour period. They concluded nearly 60% of the videos they looked at from nonmedical influencers, or TikTok users who didn't identify themselves as medical professionals, contained inaccurate or misleading information. That compares to nonfactual information in 15% of videos from medical professionals.

Compounding the problem: Videos from nonmedical influencers were far more popular and visible on the app, according to the study.

"It's kind of a coin toss if something's accurate or it's not," Roxbury said. "I wouldn't put my health in a coin toss."

Overall, 44% of all videos included information that those studied described as "nonfactual." Some videos included in the analysis didn't seek to spread information or tips, but instead are comedic or serve a different purpose.

The algorithm used by TikTok is hard to pin down and has fascinated users for years. The app serves users tailored content, boosts certain creators and has become a breeding ground for viral videos. But that isn't necessarily the best place for important, accurate health information to thrive, Dimitroyannis said. "The more you post, and the more you post similar content that has gotten popular, the more [engagement] you'll get," she said. "That's not necessarily the best environment for health information that's been rigorously examined."

The study looked at a video's views and shares per day , the uploader and the quality of the video. It also considered reliability, how easy it was to understand and whether it provided information that could be acted on. Researchers also analyzed a video's potential harm and benefit.

While the study, published in March, focused specifically on sinusitis, the conclusion likely can apply to other ailments, Roxbury and Dimitroyannis said, and it calls attention to the need to see a doctor for the best, most personalized advice.

"Take everything you see with a grain of salt," Dimitroyannis said. "Just because it's your favorite influencer, take it for what it is. Do your own research, and before you do anything talk to a medical professional."

Health misinformation spreading on social media became a hot-button issue during the height of the COVID-19 pandemic, prompting such organizations as the National Center for Biotechnology Information to sound the alarm on the spread of inaccurate information on social media.

"The reliance on social media platforms for news consumption during the COVID-19 pandemic has amplified, with dire consequences for misinformation sharing," the biotechnology group found in a 2022 study.

Dr. Zachary Rubin, an allergist at suburban practice Oakbrook Allergists, said he posts on TikTok to provide accurate health information and debunk some myths that may spread on the platform. In some examples, he responds to videos from people asking why their allergies seem more severe this year and provides tips to people using EpiPens to counteract an allergy. His account, @rubin_allergy, has more than 1.2 million followers.

"This is something that is not just a TikTok problem, it’s a social media problem," he said. "The majority of adults will search for health-related issues online. You’re gonna find a lot of accurate information, and you’re gonna find a lot of bad information."

Rubin, who started posting on social media during the height of the pandemic to connect with people, also pointed out that the short-form video format can make it difficult to contextualize information and fully explain benefits and risks .

He makes some videos that respond to other influencers, providing context or debunking some tips and tricks that may be ineffective or dangerous. For example, Rubin expressed concern about popular videos suggesting raw milk instead of pasteurized milk, which could be linked to bird flu, according to recent reports. But it's important to consider how to approach those situations, he said.

"It’s always important, even if you don’t agree with somebody, to come from a place of kindness and respect, but also be firm in my credentials and what I know," Rubin said.

Some "tips and tricks" shared on the app, while not necessarily harmful, aren't based in science. And some are downright strange, like shoving garlic in your nostrils to combat sinus issues or placing potatoes in your socks at night to "draw out toxins."

While some methods aren't harmful, they can go awry. For example, if you get a clove of garlic stuck in your nose, you may need surgery to get it out, Roxbury said.

Numerous videos on TikTok show users removing garlic from their nostrils, causing mucus to drain from their noses. But that doesn't mean, as some videos claim, that the garlic relieved their sinus issues — rather, it's because the garlic irritates the nose, producing mucus, according to University of Chicago researchers.

A video, which has more than 3,700 likes, posted by @maryjopaige, for example, shows a woman pulling garlic cloves out of her nostrils. Mucus drips from her nose as she laughs and remarks, "Oh my God!" The text on the screen reads "garlic in your nose for 10 minutes, clears sinuses." It's unclear whether the video was included in the study, but the caption includes the hashtag #sinusinfection, which was one of those used. The user didn't respond to a request for comment.

TikTok has a rigorous policy to stem misinformation, according to a spokesperson. Depending on the harm level of the information being spread, some videos are taken down, while others are limited in their reach, meaning they won't show up on the "for you page" served to users, and they'll be harder to search for.

The platform also displays a banner when users search health-related terms, including the search "Do I have a sinus infection?" reminding them to consult a doctor.

"TikTok is not a substitute for medical advice," the alert reads. "We encourage you to reach out to a healthcare professional or helpline."

While TikTok follows a policy regarding misinformation, the app doesn't prohibit people from posting about their personal experiences, myths or misinformation that would cause the poster "reputational or commercial harm" because the platform seeks to strike a balance between "creative expression" and "preventing harm," a spokesperson said.

The app also has a team of fact checkers around the world who verify information in videos, the spokesperson said. As of last year, the app removed 97% of videos with misinformation that violated its policies before they were reported by a user.

Roxbury, who teaches at the University of Chicago and practices rhinology at the University of Chicago Medical Center, said it's common for people to come into his clinical practice wielding information they saw online, whether from social media or a health search engine like WebMD.

A common example is someone with sinus issues who has self-diagnosed a sinus infection asking for antibiotics because they have worked for a similar problem in the past. Sometimes they're facing something like allergies instead, and antibiotics would be an improper treatment, Roxbury said.

"Instead of continuing to have this patient get treated with antibiotics, probably improperly so, we can get them on the right track," he said. "Sure, it's fine to look at the internet and see what's going on, but a lot of times there's no substitute for seeing the doctor."