In this episode of the Good GP, host Dr Maria Li welcomes back Dr Katherine Wyld, endocrinologist, for the third and final part of the series on hormone pseudoscience. Focusing on adrenal hormone-related misinformation, commonly encountered both in general practice and on social media.

Dr Wyld tackles the adrenal hormone-related prevalent misinformations, including:

• The widespread misinformation about adrenal hormones, especially related to cortisol, circulating on social media and online platforms. Cortisol testing requires careful consideration of context and timing, as cortisol levels fluctuate significantly throughout the day.
• Dr Wyld clarifies that single-point cortisol measurements are rarely clinically meaningful, and that salivary and urine cortisol tests should only be used in specific, evidence-based situations.
• Dutch testing (dried urine testing for hormones) is not supported by endocrine societies due to lack of evidence, questionable logic, and high cost.
• “Adrenal fatigue” is not a real or recognized medical condition; there is no scientific evidence or data to support this concept.
• High cortisol is commonly blamed for stress, anxiety, weight gain, and fatigue, but it is rarely the cause unless clear evidence of Cushing’s syndrome is present. Features of Cushing’s syndrome to look for include diabetes, hypertension, significant unexplained weight gain, skin changes, and proximal myopathy.

Sharing strategies for GPs when faced with unfamiliar symptoms or patient requests based on pseudoscientific information. Dr Wyld encourages clinicians to be honest about knowledge gaps, consult reputable sources, and maintain open communication with patients.

Links & Resources: 

• Endocrine Society of Australia - https://www.endocrinesociety.org.au/
• US Endocrine Society - https://www.endocrine.org/
• Adrenal Fatigue patient handout - https://www.endocrine.org/patient-engagement/endocrine-library/adrenal-fatigue

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