Doctors learn about hormonal disorders in medical school, as they learn about so many other things. But the medical school curriculum stresses that hormonal disorders are usually rare. Not only is this not true, but it does a disservice to endocrinologists, who study hormones and hormonal disorders, and patients, who are told that the problem lies elsewhere. Medical schools do teach about hormonal disorders in their extreme cases but may not teach about less severe cases of the same disorders. The flaws of medical education don’t stop there. In med school, the blood test is emphasized as the be-all and end-all. Symptoms may be brushed aside if blood tests are “normal.” But blood tests can be wrong. Many people with hormonal problems can have normal blood test results.
In real life, hormonal disorders can occur in many ranges and due to many things. Some hormonal disorders are caused by tumors (sometimes cancer, sometimes not) of glands — the glands pump out tons and tons of a particular hormone. Other hormonal disorders are caused by complete failure of a gland. Other problems can occur when hormones aren’t made properly or don’t function the right way.
Medical schools don’t teach much about the hormonal disorders caused by a mild overproduction or a mild deficiency of a hormone. They also don’t teach much about receptor problems or other ways that a hormone could go haywire. The result: over the years, many doctors forget to look for any type of hormonal disorder. Why should they? They’ve been practically trained to ignore them. But that can have costly effects for patients in more ways than one.
Many overweight patients seek advice from their physicians. They are usually told their hormones are normal. “It’s not your hormones,” they say. “Just eat less and exercise more.” Meanwhile, the doctor may think to herself, “This poor obese patient. I know that the odds are less than 2 percent that they will ever lose weight, so why even bother to try.” This attitude has become so prevalent that doctors now openly debate the utility of trying to have their patients lose weight at all.
Sometimes doctors miss severe hormone problems because they are not in the frame of mind of looking for them. I have seen many of these missed cases. For example, the average patient with Cushing’s syndrome (a disorder resulting in excess cortisol production and weight gain) sees multiple doctors and waits about 10 years before getting an accurate diagnosis. Doctors may ignore subtle complaints, and attribute your problems being overweight, getting older or feeling depressed. They forget to consider that perhaps your symptoms may be clues to the cause of your weight gain, not because of it.
Many hormonal disorders will make you gain weight, and all the dieting in the world will not help until the hormonal disorder is corrected. Maybe a simple blood test won’t find them, but other testing methods can – and hormonal testing techniques continue to improve. We can detect hormones in blood, urine and even saliva. But even there, a well-trained doctor will know what else to ask for, because tests can only go so far: they should be given at certain points of the day, test certain parts of the body, and other specifics that many doctors aren’t aware of.
Talk to your doctor. Your symptoms will help guide your doctor to making a diagnosis. My book, Hormonal Balance explains how doctors diagnose hormonal disorders and helps you understand what your symptoms might mean.