Comments and Controversies on Hormones Demystified

One of my earliest posts, T3 Or Not T3 – Exploring The Controversy, typically garners more views and generates more comments on a daily basis than any other post on Hormones Demystified. Using views and comments as the standard yardstick for internet success, I should be celebrating this as a win. I’m not.

Despite the assertions of disgruntled readers who don’t believe that I empathize with their struggles (I do), I do not run this blog to satiate a God complex. Rather, my mission has always been to provide a place where both patients and physicians can come to learn a few things and perhaps have a few laughs along the way. The irreverent tone with which I usually write is sometimes mistaken for contempt for my patients; while I understand how people might connect the dots in that fashion, I assure you that I care deeply about your well-being and safety. While I do sometimes call you out for being your own worst enemy when it comes to managing your health, I reserve the vast majority of my scorn for the purveyors of alternative medicine, who often victimize my real-life patients as well as my blog readers.

So why am I telling you all this? For a while now, I’ve been a little uncomfortable with the direction in which the T3 post’s Comments section has moved. Since the blog’s inception, my philosophy regarding comments has been to allow anyone to say anything, with very few exceptions. In my opinion, that has generally created a hospitable environment for maximal reader engagement. While I prefer that people refrain from ad hominem attacks, you have always been welcome to say as many nasty things about me as you like, as long as your comment also contains some meaningful substance that provides useful context for other readers. As such, I can probably count the number of comments that I’ve deleted/redacted over the years on one, maybe two hands.

As time has progressed, it’s become fairly easy for me to tune out the haters, while still keeping one ear open for the valid points they make. Unfortunately, my permissive approach to comments has allowed a different kind of objectionable comment to flourish – the kind that espouses some of the same non-evidence-based claims that this blog was created to debunk. Worse, some of these comments are framed as specific medical advice from one reader to another. While I do not object to readers drawing different conclusions from mine when data are far from conclusive, I do object when they present their conclusions as fact and recommend diagnostic/therapeutic strategies to other commenters. Throughout my blog, I have taken pains to clearly differentiate between statements of fact and those of my opinion; I expect readers to do the same, especially when they endeavor to advise other readers.

On one hand, I appreciate the fact that people are using the Comments section as a forum for peer support. I want this blog to be a safe space for people to get good, evidence-based information. It’s like having the house where all your kids’ friends come to hang out; even if you overhear some questionable things coming out of their teenage mouths, you’d much rather have them at your place under your watch – as opposed to some other house where the mom is working late and the dad is passed out after imbibing three too many whiskeys.

On the other hand, my policy of not providing individualized medical advice has inadvertently created a vacuum, which some well-meaning and intelligent readers have moved to fill. Unfortunately, this has resulted in the dispensation of some reader-to-reader advice, with which I often don’t agree. I have been loath to intervene, as I am not running a medical consultation service and do not have the time nor desire to be drawn into such discussions. However, I am also concerned that people might interpret my lack of participation as tacit approval of such reader-to-reader advice.

I therefore find myself as the owner of the house where all the teenagers are hanging out, presumably not getting into too much trouble under my watchful gaze. But when I go outside to mow the lawn, they’re furtively engaged in heavy petting behind a closed door, thankful that I’m the cool parent who doesn’t mind this sort of thing. Today is the day I’m telling you, that’s not the case – I mind¹.

There’s a New Sheriff in Town

I’ll be honest: I don’t know exactly where to draw the line when it comes to comments. Just as parenting didn’t come with a handbook, anti-quackery blogging is a niche space without robust, best-practice guidelines. Given that this enterprise is incredibly subjective, it is likely that any attempts I make to redact, clarify, or delete reader comments will upset some people. Please accept my apologies, in advance. For now, I plan to take a page out of Supreme Court Justice Potter Stewart’s concurrence in the famous Jacobellis v. Ohio case of a theater owner who was convicted of showing an “obscene” film. Justice Stewart, referring to hard-core pornography, said “I shall not today attempt further to define the kinds of material I understand to be embraced within that shorthand description…But I know it when I see it, and the motion picture involved in this case is not that.”

At this moment, I cannot give you firm guidelines spelling out what is and isn’t allowed. Perhaps the tincture of time will lead to greater specificity. I can, however, promise that I intend to allow robust discussion of conclusions with which I don’t necessarily agree, as long as they are not demonstrably false and are clearly presented as opinion – not unassailable fact.

Bringing this back around to my 2017 T3 post….I will begin publishing a series of shorter posts, each one addressing a controversial claim made or piece of advice rendered in the Comments section of the original T3 post. I will close out the 2017 post to new Comments, encouraging all future discussion to take place in the Comments of the appropriate post in my newer T3 series.

Hopefully, this course correction will achieve the desired outcome of providing you with the most reliable, evidence-based information that you can find on an Endocrinology blog. If not, I’ll pick up the pieces and try something different. Thanks for hanging in here with me.

–HD

Image Credit: Photo by Tobias Tullius on Unsplash

1. Before you get bent out of shape that I’m being paternalistic or condescending by comparing readers to teenagers, I’m simply attempting to employ a colorful analogy – for entertainment’s sake. I don’t view you as children [↩]