For better or worse, we've all consulted "Dr. Google" a time or two, convinced we can self-diagnose, or at least get a better understanding of our symptoms, before going to the doctor.
Or maybe it's more than once or twice. According to a recent survey in Healthline, a popular online provider of health information, Americans are turning towards social media and search engines more often than doctors to learn about health and wellness. Specifically, 52% said they sought answers from social media and 37% utilized search engines. Only 34% consulted a doctor or health care provider.
The problem is, not all information out there is reliable. In a recently published review of more than 200 popular sinus infection videos on TikTok, University of Chicago researchers found that most of the ones posted by nonmedical influencers were inaccurate, despite being portrayed as medical advice or educational. All told, the videos garnered more than 300 million views and 1 million shares.
In addition, googling symptoms can lead to unnecessary anxiety — and emptier pocketbooks if you're buying supplements or teas claiming to "support immunity," "protect against dementia" or "promote heart health." There is no evidence the vast majority of supplements can prevent or cure illness and, in fact, some may even increase the risk of developing certain conditions.
Still, it's human nature to self-educate. The ancient Greek philosopher Socrates, after all, famously advised people to question everything.
"I enjoy listening to patients as they share with me what they've read and express their opinions," says Dr. Nathan Starke, a men's health specialist at Houston Methodist who calls medicine a team sport. "In my experience, the patients who visit their primary care provider regularly, do their research, ask questions and are curious about their symptoms or conditions are better stewards of their own health."
But at what point can patient questioning and speculating lead to unhealthy consequences? Can patients be too skeptical about their health? Through the lens of men's health, Dr. Starke explores when questioning and speculating can help — and hinder — us in the pursuit of becoming better overseers of our own health and wellbeing.
Should I take this vitamin or that supplement?
Dietary supplements are a multi-billion dollar industry, with a $43 billion market value in 2022 and an expected market value of $70 billion by 2031, according to Statista. Per the FDA, dietary supplements can be beneficial to your health when diet alone cannot meet your daily requirements of essential nutrients.
For example, 31 out of every 100 non-Hispanic Black Americans are at risk for vitamin D deficiency, and women ages 20 to 39 have lower iodine levels than any other age group, according to a CDC nutrition report. Iodine is a critical nutrient during pregnancy for normal development of the baby's brain.
However, the FDA says supplements can also pose "health risks," ranging from medication interactions to an increased risk for certain types of cancer.
One classic example of the latter: vitamin E and selenium supplements for prostate cancer. The two nutrients were once thought to reduce the risk of developing prostate cancer, to the point it almost became "a word of mouth-based standard of care" for some providers to recommend vitamin E, says Dr. Starke. But a high-profile study ultimately found that neither supplement decreases the risk of developing prostate cancer or lessening its severity and, instead, may actually increase the risk.
Other studies have also shown that certain supplements can increase cancer risk. The supplemental use of beta-carotene — an antioxidant — is actually associated with an increased risk for developing lung cancer among people who smoke.
Some supplements, however, may just produce "expensive urine," a tongue-in-cheek term used to describe the idea that taking unnecessary vitamins and supplements is a waste of money because the body excretes any excesses in urine. In Dr. Starke's line of work, this is often seen with male fertility supplements.
"There's a big market for fertility vitamins, and there have been lots of studies about what nutrients sperm need in vitro," Dr. Starke says. "CoQ10 is one of these nutrients that is sold as a quite expensive supplement and is thought to be a fertility aid or booster."
"In vitro," he adds, "there is a relationship between sperm health and CoQ10 and zinc, among others, but there's no solid evidence that putting lots of it in your stomach is going to have any dramatic impact on the way your body makes sperm."
"I love when patients ask me about these supplements they hear about," he says. "In the case of CoQ10, taking it in supplement form is unlikely to hurt you, but it hasn't been well established to dramatically boost a man's fertility."
Ultimately, some supplements can be beneficial to your health, others harmless and some may end up putting your health at risk. Consult with your health care provider on what, if any, supplements you should and want to take.
What type of blood work and screenings do I need?
Screenings are those preventative tests that help doctors check for diseases and health conditions before there are any signs or symptoms. Most conditions are easier to treat when they are discovered prior to symptoms.
Blood pressure tests, blood work like prostate specific antigen (PSA) tests and cancer screenings like mammograms and colonoscopies are all examples of life-saving tests. But without signs or symptoms, how do you know which ones are right for you?
"The bloodstream is one of the primary conduits our body uses to distribute a variety of chemicals, proteins and signals," says Dr. Starke. "Being able to quantify some of those signals is key to figuring out what your body is doing and, if anything, what's missing."
According to the CDC, roughly 70% of today's medical decisions depend on laboratory test results. Blood work is one of the most common types of lab tests performed and is used by doctors to investigate a variety of issues, including:
- Diagnosing and monitoring diseases and conditions
- Checking how well your organs are working
- Finding out if your immune system is having trouble fighting infections
Some of the most common conditions that blood works tests for include:
- Metabolism
- Cholesterol
- Diabetes
- Hormones, like testosterone
- Thyroid function
- Liver function
- Kidney function
- Sexually transmitted infections (STIs)
- Inflammation
Blood work and screenings are vital to our long-term health and wellbeing, but according to Dr. Starke, there are limits to what they can reveal. In addition, he notes, overtesting can sometimes lead to more problems than not.
"Problems occur when you undergo medical testing without any specific medical questions in mind," Dr. Starke says. "A lot of the information gained about this or that level, without good scientific evidence for why you're testing, doesn't necessarily have any real-world applicability or meaning."
"Just because a test reveals a result 'outside the normal range' doesn't mean that there is a scientifically backed response to that test that will affect any specific health outcome," he adds.
Conversely, low testosterone (or low T) is an example of a historically ignored lab value that doctors have only recently become proficient in treating effectively and safely, says Dr. Starke. Low T is not only associated with lower libido. It also can affect your muscle mass, body fat, mood and sleep habits — general enough symptoms for Dr. Google to mislead or misdiagnose.
"Low T is generally thought of more as a quality-of life measure rather than something dangerous that must be treated," Dr. Starke says. "But it's something beyond the standard blood workup primary care doctors order up that can be tested, and the treatment is well-established to positively affect people's lives. There is also good evidence emerging that low T may negatively impact things like cardiovascular and bone health, and future treatment guidelines may include stronger language to reflect this stronger evidence."
Be skeptical of your own skepticism
So do you really need your cortisol levels checked, convinced your puffy cheeks are due to what the internet is now calling "cortisol face" from high levels of the stress hormone circulating in your blood?
Or perhaps you've seen influencers promoting full body scans to detect health issues that might be caught earlier than the evidence-based screens and tests recommended by the U.S. Preventative Services Taskforce?
"The U.S. Preventative Services Task Force tries to balance the utility of a test in finding disease versus the possibility of false positives, unnecessary testing and the cost," says Dr. Starke. "Full body scanning is, at least in terms of the greater good, not well established to be good for any given population."
Unfortunately, according to a 2021 survey published by the Harvard TH Chan School of Public Health and the Robert Wood Johnson Foundation, nearly half of Americans do not have high trust in the CDC, FDA and other major public health organizations when it comes to recommendations to improve health.
Dr. Starke acknowledges that many people are skeptical of traditional medicine. He advocates those people apply the same skepticism to practitioners willing to run "out of the box tests" like full body scans or 100-plus lab tests, which analyze blood for over 100 different biomarkers to assess various aspects of health beyond what routine blood tests cover.
"People should be skeptical the whole way through," he says. "Inquisitiveness, curiosity, openness and collaboration are traits that will ultimately make patents better guardians of their own health."
