Doctors, Wellness Influencers, and Probiotic Gummies: A Cross-Sectional Analysis of Gut Health Claims and Financial Conflicts on TikTok

TikTok has emerged as a major source of health information, yet concerns persist regarding the accuracy of content and influence of financial conflicts. Gut health content is particularly vulnerable to misinformation. This study examined the relationship between creator profession ("medical" versus "non-medical") and the quality of gut health claims and the presence of financial conflicts on TikTok. We conducted a cross-sectional study of 412 TikTok creator accounts identified using the search terms "guthealth," "gutcleansing," and "digestion." One video per creator was analyzed. Creator profession was categorized as medical or non-medical. Health claim quality was coded as high, moderate, or poor. Financial conflicts (Showcase, Subscription, external links) were assessed. Modified Poisson regression was used to estimate prevalence ratios (PRs) of health claim quality (high versus poor- or moderate-quality) and financial conflicts between medical and non-medical creators, and negative binomial regression was used to evaluate associations between claim quality and number of video likes. Non-medical creators were more likely than medical creators to present poor- or moderate-quality health claims (adjusted PR: 2.33; 95% CI: 1.50-3.62). Most creators (92%) exhibited at least one financial conflict, and Showcase use was greater among non-medical creators (adjusted PR: 1.57; 95% CI: 1.02-2.42). Videos containing moderate- and poor-quality health claims received three times as many likes as videos containing high-quality claims. Non-medical creators disproportionately produced lower-quality gut health content on TikTok, and misleading claims received greater engagement. These findings highlight a misalignment between information quality and visibility, emphasizing the need for interventions promoting evidence-based health communication.