It’s hard to believe I’ve been doing this for three years now. Fortunately, I’m particularly susceptible to inertia, which has made it fairly easy to continue doing what I launched back in March 2017. Regular readers will remember the victory lap I took in March 2018 after achieving all the goals I set out in my original mission statement. My two-year update in 2019 was not quite as dramatic, but there was some meaningful stuff in there, including the cliff-hanger about a talk I was asked to give to a national audience of Endocrinologists – so let’s kick off the year-in-review with that!
I did, indeed, speak to an audience of Endocrinologists at a national conference. At the risk of affirming the conclusion many of my readers have drawn that I have a God complex – I killed in that room. I swear to you six ways from Sunday that I am (mostly) humble in real life, but my talk was damn good, and it’s thanks to you, my readers.
I spoke about how to approach interactions with patients who are invested in alternative medicine – one of the toughest situations with which we deal in Endocrinology. After all, much of what alt med preaches is antithetical to what we endorse. What made my talk unique compared to others in the genre is that the first half of my lecture was dedicated to why patients seek out alt med in the first place. In order to help my audience gain a better appreciation for the reasons, I used anonymized quotes from my readers, which were poignant, instructive, and often heart-breaking.
After laying out the why‘s, I then launched into how I think physicians can try to help these folks when it is often quite difficult to do so. I can only hope that at least a few doctors in the audience took one nugget of wisdom back with them to their practice of medicine.
Sounds great, HD. But you know what we’re all wondering right about now…aren’t you supposed to be anonymous?
Yeah, I figured you’d point that out eventually. When I was approached with this opportunity, I made it clear that I wasn’t ready to come out of the anonymity closet. The meeting organizers were surprisingly understanding about that, allowing me to deliver the talk as HD1. Sure, there were people in that room who know my identity, but the majority of them just know what I look like. Even I look back on it and think, “Wow, that was weird.”
Big Year for Thyroid
The little gland in the front of the neck consumed most of my blog real estate this year. This shouldn’t be shocking, given that there’s more bull-feces slung by alt med about the thyroid than about any other aspect of Endocrinology.
In Is TSH the Best Test?, I penned an evidence-based defense of the oft-maligned thyroid stimulating hormone (TSH) as the most sensitive indicator of one’s thyroid status. Sure, there are some caveats to that, but for the vast majority of people with hypothyroidism, none of the other thyroid function tests on the menu are going to add much actionable information.
A reader’s email inspired the highly topical Do Keto and Fasting Wreck Your Thyroid and Metabolism? This was a fun post to write, as I was able to offer a whole lot of opinion without having to back it up with tons of hard data – because those data are thin to none for this particular topic. Now I know how the authors of alt med sites feel – it’s quite liberating to be able to say whatever I want and not have to prove it’s actually true.
I got a little snarky in Everyone is Hypothyroid, and then I followed it up a couple of months later with a thorough, evidence-based debunking of the utility of BBT in Basal Body Temperature and Your Thyroid: Why I Don’t Care and Neither Should You.
One of my favorite posts of the year was Thyroidectomy for Hashimoto’s? In it, I explored how cultural differences in how Americans perceive health and disease could have dramatic implications for the interpretation and applicability of a Norwegian study that seemed to show symptom improvement for Hashimoto’s sufferers after thyroidectomy.
The T3 Controversies Series is Born
In Comments and Controversies on Hormones Demystified, I dedicated an entire post to explaining why I shut down the Comments section on one of my most popular posts of all time, T3 Or Not T3 – Exploring The Controversy. The TLDR version: some readers were espousing views and giving advice to other readers that often looked like something you would find on QuackyThyroidBlog.com as opposed to Hormones Demystified.
I’m determined to turn this into a win, however, which is why I embarked on a mission to counter many of these non-evidence-based claims in my T3 Controversies Series. The first three have been well-received, so check them out if you haven’t yet done so:
- T3 Controversies: Can Impaired Thyroid Hormone Action be Treated with T3?
- T3 Controversies: What About Tissues That Can’t Make T3?
- T3 Controversies: Should T3 Levels Be Normal When Treating Hypothyroidism?
Speaking of Shutting Down Comments…
Some of you may remember one of my earliest posts from 2017, Top 10 Things To Tell Your Endocrinologist To Make Her Cringe…. Over the years, it has sparked a fair amount of anger among many readers, while a few appear to understand the satire. Many comments have expressed pure vitriol and outrage; others have been a measured appeal to my sense of mission, suggesting that I take the post down, as it could turn off would-be acolytes to my message of science and reason.
After years of reflection, I’ve decided to leave the post up but shut the Comments section down. You may not agree with my decision, but I’ll explain anyway.
First, I still believe the post is very, very funny – especially if you’re a physician who gets the gallows humor, and I have many physician readers. That’s enough for me to feel like it’s a valuable contribution to the blogosphere.
Second, I believe that my irreverence and lack of self-censorship are attributes that have contributed to Hormones Demystified being one of the most widely read Endocrinology blogs in the world2. While I do think that my tone has softened over time – probably the subtle influence of learning the makeup of my core audience – I don’t plan to actively betray the integrity of my voice.
Third, and this is critical: I want to shine a light on the concept that the world is not a binary place. So many commenters have clearly convinced themselves that I am evil and devoid of empathy. Historically, I allowed these comments to proliferate, as I assumed that it might be a catharsis for some to chew me out, and it’s my mission to help people in whatever way I can. Unfortunately, through benign neglect, I’ve allowed the haters to drown out the fact that there is nuance to be found here. Finding humor in the exam room and having empathy are not mutually exclusive, and I will no longer allow the haters to insist that the relationship is binary.
I don’t plan to defend the Top 10… post any further than what I’ve already written throughout its Comments section and in today’s post. In the immortal words of Forrest Gump:
Other Standout Posts
Coming In As Transgender was an eye-opening way to conceptualize the journey of being transgender. Physician Online Biographies: What We Really Want to Say should have inspired an ice-bucket challenge-esque movement among doctors to revise their online profiles. Unfortunately, I have no interest in or significant engagement with social media, so I didn’t press the issue. But it’s still a fun read.
I explained why potassium is the most underrated nutrient when it comes to lowering blood pressure in The Hypertension Cure. And finally, I delivered the type of rant you’ve all come to know and love in Top 5 Reasons Why You Shouldn’t Order Your Own Blood Tests.
What’s on Tap for Hormones Demystified
As of the writing of this post, the world is freaking out about the novel coronavirus, which causes the illness COVID-19. It is consuming both the news and everyone’s attention, causing much worry and stress in the process. In an effort to provide a little comic relief, the next post I publish will likely be a special one I’ve been saving for a rainy day. I’ll tease it: my daughter wrote about what it’s like to live with HD, and she doesn’t pull punches. Ouch.
As for the rest of year four, you can expect to see some more posts in the T3 Controversies Series. I have several other ideas for non-thyroidal posts in the hopper, so I guess we’ll just have to see what lights my fire at any given moment. I was contacted about another speaking engagement, but that one isn’t going to come to fruition, so I’ll just be here, in my hole, getting riled up over all the ways alt med concocts to siphon your money, time, and energy.
As always, thank you for reading. If you like what you see, please share it loudly and widely, as we need to counter the cacophony of quackery that dominates the internet.
By reading this site and interacting with me and others in the Comments, you agree to abide by my Disclaimer. As always, it is against my policy to give individualized medical advice, so please refrain from asking.
Image Credit: Photo by Matthew Cabret on Unsplash
9 Replies to “Hormones Demystified: Three-Year Update”
Thank you and congrats. Write a book. Some balance is needed in the thyroid/autoimmune mass market press. I have a doctorate. I’m a professor in a medical campus. I receive NIH funding. As a patient, I had the hardest time sorting out useful info versus quackery. And yes, in part I do blame busy endocrinologists.
Great point. Highly educated people have a hard time separating the wheat from the chaff, which also speaks to how good Alt Med is at making their BS sound reasonable.
Congratulations HD! Always informative and witty, with a unique perspective and voice. Keep it going!
While I don’t agree with everything in the blog, I do appreciate a counterpoint to alt med. Probably the most important things I have got out of the blog is understanding how to talk to my Endocrinologist, what they believe in, and what is reasonable to ask them. I still think there are a lot of potential in some alt med claims which I’d like to see more research (gluten, diet, nutrient deficiency help). I also think there is a lot of work needed in the understanding and use of combination therapy (and I really do think most of the time it is the thyroid for patients). All that being said, there are good nuggets here. Something you may want to do is convince more endos to consider writing blogs or engaging in social media. You are outnumbered 1000 to 1 (and a few sites that are in-between alt and mainstream). Thyroid patients have a very hard time figuring out what to believe and what not to. That in itself is a journey (as much as the disease is).
Thank you for a good three year, and I’toasting you in coffee to the next at leasst three years!
I have to get a new keyboard, and remember to check my posts.
HD, Congrats on your anniversary. I eagerly await each month’s post. Some topics I’d like to see addressed relative to their scientific validity: mast cell activation syndrome (MCAS), histamine intolerance, and of course, drum roll …. the microbiome and relationship to autoimmunity and allergy. Thanks!
I second these topics!