Unethical Practices and Deceptive Claims in Health Diagnosis

In this episode, Greg and Lyndsey sit down for a discussion about cortisol with Beth Skwarecki, the senior health editor at Lifehacker. The dangers of high cortisol are a persistent topic of content on social media content, so the discussion focuses on the types of claims that are being made, the dubious methods of self-diagnosis and “treatment” being recommended, and the potential risks and dangers associated with letting social media convince you that you’re basically an endocrinologist.

You can read Beth’s article on this topic here: TikTok Myth of the Week: All Your Problems Are Due to High Cortisol

TIME STAMPS 

What is cortisol? (00:02:52)

• Epinephrine vs. Adrenaline
• Basic cortisol physiology
• Low cortisol and adrenal crisis

 'Normal' cortisol levels (00:18:44)

• Reference range for normal cortisol
• Variability in cortisol awakening response
• Cortisol awakening response poorly associated with total daily cortisol AUC
• Early childhood stress (with family income as a proxy) associated with either elevated or depressed cortisol awakening response

Cortisol discourse on TikTok (00:33:56)

Representative examples of TikTok cortisol content:

• https://www.tiktok.com/@brittwd/video/7263934911432707374?_r=1&_t=8gQo2Q04An4
• https://www.tiktok.com/@mallorymh/video/7242431357446556970
• https://www.tiktok.com/@xomgitsbunnie/video/7272557452095376686
• https://www.tiktok.com/@liv.ingwell/video/7263106370696695083

Cortisol vs other social media trends (00:47:48)

• The Endocrine Society on adrenal fatigue
• Representative examples of TikTok adrenal fatigue content: https://www.tiktok.com/@clairethenutritionist/video/6964559576985308421?_r=1&_t=8gY2Pf0iBPn
• https://www.tiktok.com/@begreatwithnate/video/7191220532862356778?_r=1&_t=8gY2YIPYDDG
• https://www.tiktok.com/@ambitiousandcaffeinated/video/7201977016571202821?_r=1&_t=8gY2fS0vaRP
• https://www.tiktok.com/@ghallfitness/video/7190694428586151170?_r=1&_t=8gY2uaAaGvS
• https://www.tiktok.com/@thewellnesswaylargo/video/7254966223329398058?_t=8gY34NUrjRO&_r=1

Cortisol and menstruation (01:07:41)

Cortisol and trauma (01:11:32)

• Representative example of movements claimed to reduce cortisol associated with trauma
• Tapping: https://www.thetappingsolution.com/

Cortisol and exercise (01:15:55)

• Cortisol and overtraining (most notably, Figure 3)
• Impact of exercise intensity on cortisol response
• Cortisol levels return to normal very soon after exercise ends
• Hackney review on exercise and cortisol

Specific claims about high cortisol (01:38:30)

Cortisol, caffeine and sleep (01:45:39)

• Plenty of things cause you to wake up at night
• Spiritual meaning of waking up at 3AM
• Caffeine and cortisol
• Caffeine’s effects on cortisol are attenuated within 5 days of consumption
• Coffee intake is associated with plenty of positive health outcomes (hard to square with the idea that caffeine spikes cortisol in a manner that’s deleterious to your health)

Real ways to regulate cortisol (01:55:49)

Self-diagnosis (02:03:08)

• Cortisol disorders can cause real disease (story Beth referenced about woman with tumor)
• Other things that can cause Cushing-like symptoms

Takeaways (02:08:13)

Where to find Beth

• Check out Beth’s writing on Lifehacker
• Beth’s 510 Dinnie Deadlift
• Beth’s books: Outbreak! and Genetics 101
• Follow Beth on Twitter

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