Abstract
Experienced providers vary significantly in their opinions regarding the optimal evaluation and management strategies for patients with pseudo-endocrine conditions. Most believe in a purely evidence-based approach that emphasizes the robustness of our current testing paradigms and the safety and effectiveness of the currently available FDA approved treatment modalities. Others agree with evidence-based diagnostic and treatment recommendations but utilize a modified approach that includes variable degrees of alternative medicine strategies in areas where no solid evidence base exists. In this chapter, I describe my own personal practice which emphasizes compassion, honesty, and an individualized approach to each patient.
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Suggested Reading
Garber J, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012;18(6):988–1028. Thyroid. 2012;22(12):1200–35.
Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, American Thyroid Association Task Force on Thyroid Hormone Replacement, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670–751.
Guglielmi R, Frasoldati A, Zini M, Grimaldi F, Gharib H, Garber JR, Papini E. Italian Association of Clinical Endocrinologists statement-replacement therapy for primary hypothyroidism: a brief guide for clinical practice. Endocr Pract. 2016;22(11):1319–26.
Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101:364–89.
Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101:3888–921.
Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1587–609.
Bollerslev J, Rejnmark L, Marcocci C, Shoback DM, Sitges-Serra A, van Biesen W, Dekkers OM, European Society of Endocrinology. European Society of endocrinology clinical guideline: treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015;173(2):G1–20.
Jerant A, Fenton JJ, Kravitz RL, et al. Association of Clinical Denial of patient requests with patient satisfaction. JAMA Intern Med 2018 Jan 1;178(1):85–91. Published Online November 27, 2017.
Pryor L. How to counter the circus of pseudoscience. New York Times, Jan 5, 2018.
Seaborg E. The myth of adrenal fatigue. Endocrine News, 2017. p. 29–32.
Schaffer R. In age of internet diagnoses, endocrinologists confront myth of “adrenal fatigue”. Endocrine Today, April 2018. p. 1–12.
Hormone Health Network adrenal fatigue fact sheet: www.hormone.org/diseases-and-conditions/adrenal/adrenal-fatigue.
Hormone Foundation (Endocrine Society) website – adrenal fatigue: https://www.hormone.org/-/media/hormone/files/myth-vs-fact/mfsadrenalfatigue-520.pdf?la=en.
Mayo Clinic website – adrenal fatigue: https://www.mayoclinic.org/diseases-conditions/addisons-disease/expert-answers/adrenal-fatigue/faq-20057906.
Akturk HD, Chindris AM, Hines JM, Singh RJ, Bernet VJ. Over-the-counter “adrenal support” supplements contain thyroid and steroid-based adrenal hormones. Mayo Clin Proc. 2018;93(3):284–90.
Donegan D, Bancos I. Opioid-induced adrenal insufficiency. Mayo Clin Proc. 2018;93(7):937–44.
Wilson’s syndrome website: http://www.wilsonssyndrome.com/meet-dr-wilson/.
Wikipedia – Wilson’s syndrome: https://en.wikipedia.org/wiki/Wilson%27s_temperature_syndrome.
American Thyroid Association (ATA) website – search for Wilson’s syndrome: www.Thyroid.Org.
State of Florida, Department of Health. Final order number: DPR9200039ME – Ruling against Wilson’s syndrome, Feb 12, 1992.
Reverse T3 syndrome website: www.stopthethyroidmadness.com.
Baillargeon J, Kuo YF, Westra JR, Urban RJ, Goodwin JS. Testosterone prescribing in the United States, 2002–2016. JAMA. 2018;320(2):200–2.
Layton JB, Kim Y, Alexander GC, Emery SL. Association between direct-to-consumer advertising and testosterone testing and initiation in the United States, 2009–2013. JAMA. 2017;317(11):1159–66.
Schwartz LM, Woloshin S. Low “T” as in “Template”. How to sell disease. JAMA Intern Med. 2013;173(15):1460–2.
Gomes-Lima C, Burman KD. Reverse T3 or perverse T3? Still puzzling after 40 years. Cleve Clin J Med. 2018;85(6):450–5.
Schmidt RL, LoPresti JS, McDermott MT, Zick SM, Straseski JA. Is reverse triiodothyronine ordered appropriately? Data from reference lab shows wide practice variation in orders for reverse triiodothyronine. Thyroid. 2018;28(7):842–8.
Muller RS. Making a difference in adrenal fatigue. Endocr Pract. 2018;24(12):1103–5.
Gota CE. What you can do for your fibromyalgia patient. Cleve Clin J Med. 2018;85(5):367–76.
Warraich H. Dr Google is a liar. New York Times, Dec 16, 2018; Page A19 of the New York Edition.
Hellmuth J, Rabinovici GD, Miller BL. The rise of pseudomedicine for dementia and brain health. JAMA. 2019;321:543–4.
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McDermott, M.T. (2019). Pseudo-Endocrine Disorders: My General Approach to Management of the Patient. In: McDermott, M. (eds) Management of Patients with Pseudo-Endocrine Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-22720-3_2
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DOI: https://doi.org/10.1007/978-3-030-22720-3_2
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