McDermott Michael T
Division of Endocrinology, Metabolism and Diabetes, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA.
J Endocr Soc. 2024 Dec 17;9(1):bvae226. doi: 10.1210/jendso/bvae226. eCollection 2024 Nov 26.
"Pseudo-endocrine disorders" refer to proposed conditions that have never been scientifically proven to exist but, due to widespread misinformation available on the internet and other media, are relatively commonly diagnosed and treated with equally unproven and sometimes dangerous treatments. Adrenal fatigue is a nonexistent condition that supposedly results from adrenal exhaustion and atrophy due to chronic stress and has been promoted as a potential explanation for a variety of symptoms. Testing consists of nonvalidated online surveys and salivary cortisol profiles while treatment is not evidence-based at best and can be dangerous. Wilson's syndrome and reverse T3 syndrome are also nonexistent conditions that supposedly result from impaired T4 to T3 conversion and competition of excess reverse T3 with T3 for T3 receptors. Testing involves measurement of axillary temperature and treatment consists of T3 therapy, often at very high and dangerous doses. Hypogonadism ("low T") is frequently diagnosed in "men's health" clinics and other venues without actual hormone testing or further evaluation and is often treated with supraphysiologic testosterone therapy that suppresses endogenous gonadal testosterone and sperm production, leads to a lifelong need for testosterone therapy, and may have numerous other harmful effects. Low-dose naltrexone (LDN) therapy has been proposed as a treatment for multiple disorders including autoimmune conditions and other disorders resulting from aberrant immune mechanisms, but there is no valid evidence that LDN has any benefits. Management of patients with pseudo-endocrine disorders must involve careful listening, patient education, healthy lifestyle measures, and honesty, encouragement, and compassion.
“假性内分泌失调”指的是一些被认为存在但从未得到科学证实的病症。由于互联网和其他媒体上存在大量错误信息，这些病症相对常见，且人们会用同样未经证实且有时危险的治疗方法进行诊断和治疗。肾上腺疲劳是一种不存在的病症，据说是由于慢性压力导致肾上腺疲惫和萎缩所致，并被当作各种症状的一种潜在解释。检测方法包括未经验证的在线调查和唾液皮质醇检测，而治疗方法充其量缺乏循证依据，甚至可能有危险。威尔逊氏综合征和反T3综合征同样不存在，据说是由T4向T3转化受损以及过量反T3与T3竞争T3受体所致。检测包括测量腋窝温度，治疗则采用T3疗法，通常剂量很高且危险。性腺功能减退（“低睾酮”）在“男性健康”诊所和其他场所经常被诊断出来，却没有进行实际的激素检测或进一步评估，而且常常采用超生理剂量的睾酮疗法进行治疗，这种疗法会抑制内源性性腺睾酮和精子生成，导致终生需要睾酮治疗，还可能有许多其他有害影响。低剂量纳曲酮（LDN）疗法已被提议用于治疗多种病症，包括自身免疫性疾病和其他由异常免疫机制引起的疾病，但没有有效证据表明LDN有任何益处。对患有假性内分泌失调的患者进行管理必须包括仔细倾听、患者教育、健康的生活方式措施，以及诚实、鼓励和同情。
