"A little learning is a dangerous thing" IOW: Don't Google before your clinic visit. [View all]

I had a patient yesterday who came in in a state of notable agitation. She said she was under severe stress, and wanted her cortisol level taken. (Cortisol is often called the ‘stress hormone’)

I talked to her to find out what was stressing her out so much (answer: everything. Work, family, divorce, insomnia, etc.) She had legit reason to be stressed out. She kept begging me to do a lab level for cortisol. Meanwhile, since I can’t take away what’s causing the stress, I was trying to work out what kind of treatment for her stress reaction would be most effective.

“Just take my cortisol level!” I finally wised up to the fact that she had Googled “Evaluate and treat stress” before her appointment. I had to tell her that a cortisol level would just tell me what I already knew, that she’s under a lot of stress. I order lab tests to either tell me what I don’t know, or to confirm what I suspect.

She said she was having trouble sleeping, but declined insomnia treatment. She was visibly depressed and crying, but declined a behavioral health referral. I finally prescribed treatment for her obvious anxiety. But I don’t know if she was satisfied with that.

She really wanted her cortisol level checked.