With more than 306 million views, #hormonebalance and #hormonebalancing are among the latest hacks to take over the social media platform TikTok, on which users post short videos. Influencers offer advice such as eating raw carrots for "happy hormones," eating protein followed by fat for breakfast to regulate blood glucose, or taking vitamin B2 supplements for thyroid health.

Raymond de la Rosa, MD

Have you ever wondered if you were asleep during the lecture on "hormone balancing" in medical school? No, you weren't. It was never a class for good reason, and you didn't fail to read any such breakthrough studies in The New England Journal of Medicine either.

Although the soundbites no doubt garner attention among TikTok users, "hormone balancing" is a fictional term that is practically meaningless.

There are over 50 different hormones produced by humans and animals, regulating sleep, growth, metabolism and reproduction, among many other biological processes, so there is certainly no one-size-fits-all solution to ensure these are all working in perfect harmony.

When someone mentions "hormone balancing," my mind wanders to the last time I took my car to have my tires rotated and balanced. If only it were as simple to balance hormones in real life. The best we can hope for is to get a specific hormone within the ideal physiologic range for that person's age.

The term "hormone" can mean many things to different people. When a woman comes in with a hormone question, for example, it is often related to estrogen, followed by thyroid hormones. A wealth of misinformation exists in popular literature regarding these hormones alone.

Estrogen can be replaced, but not everyone needs it replaced. It depends on variables including age, underlying medical conditions, the time of day a test was drawn, and concomitant medications. Having low levels of a given hormone does not necessarily call for replacement either.

Insulin is another example of a hormone that can never completely be replaced in people with diabetes in a way that exactly mimics the normal physiologic release.

There are many lesser-known hormones that are measurable and replaceable but are also more difficult to reset to original manufacturer specifications.

A Google search for "hormone balancing" often sends you to "naturopaths" or "integrative medicine" practitioners, who often propose similar solutions to the TikTok influencers. Users are told that their hormones are out of whack and that restoring this "balance" can be achieved by purchasing whatever "natural products" or concoction they are selling.

These TikTok videos and online "experts" are the home-brewed versions of the strip-mall hormone specialists. TikTok videos claiming to help "balance hormones" typically don't name a specific hormone either, or the end-organs that each would have an impact on. Rather, they lump all hormones into a monolithic entity, implying that there is a single solution for all health problems. And personal testimonials extolling the benefits of a TikTok intervention don't constitute proof of efficacy no matter how many "likes" they get. These influencers assume that viewers can "sense" their hormones are out of tune and no lab tests can convince them otherwise.

In these inflationary times, the cost of seeking medical care from conventional channels is increasingly prohibitive. It's easy to understand the appeal of getting free advice from TikTok or some other internet site. At best, following the advice will not have much impact; at worst, it could be harmful.

There are some things that should never be tried at home, and do-it yourself hormone replacement or remediation both fall under this umbrella.

Generally, the body does a good job of balancing its own hormones. Most patients don't need to be worried if they're in good health. If they're in doubt, they should seek advice from a doctor, ideally an endocrinologist, but an ob/gyn or general practitioner are also good options.

One of the first questions to ask a patient is "Which hormone are you worried about?" or 'What health issue is it specifically that is bothering you?" Narrowing the focus to a single thing, if possible, will lead to a more efficient evaluation.

Often, patients arrive with multiple concerns written on little pieces of paper. These ubiquitous pieces of paper are the red flag for the flood of questions to follow.

Ordering the appropriate tests for the conditions they are concerned about can help put their minds at ease. If there are any specific deficiencies, or excesses in any hormones, then appropriate solutions can be discussed.

TikTok hormone balancing solutions are simply the 21st-century version of the snake oil sold on late-night cable TV in the 1990s.

Needless to say, you should gently encourage your patients to stay away from these nonFDA-approved products, without making them feel stupid. Off-label use of hormones when these are not indicated is also to be avoided, unless a medical practitioner feels it is warranted.

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TikTok Offers to 'Balance Your Hormones' Are Pure Hokum - Medscape