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Sangeetha Nadarajah is a family and aesthetic physician in Vancouver.

Being a millennial physician has its advantages. One is knowing exactly which TikTok and Instagram trends patients are referring to when they come in for an appointment.

These days, social media is flooded with health ”hacks,” opinions and experiences from people around the world, both well-respected experts and ordinary people alike. As a result, I often encounter patients who have “self-triaged” or self-diagnosed a potential health issue using information they saw online before setting foot in my office.

Social-media “self-triage” often happens after someone has been watching a seemingly endless array of TikTok advice related to their concerns. Contrary to what you might think, as a physician I do see some benefits to having this information readily accessible to the general public.

Access to health information is an essential social determinant of health, and in an ideal scenario, social media can improve our access to this information. Online, people can benefit from listening to a reputable health care provider’s expertise, or hear inspirational stories from those sharing their real-life health experiences. Social media provides a safe space for discussion because people can be anonymous, which can help them be more honest and vulnerable. TikTok viral health trends are prompting patients to actually go to their doctor’s office to discuss what they saw online and how it might relate to their own health, providing them with both the language and confidence to do so.

Lately, I’ve wondered if we’ve managed to reach the pinnacle of accessible wellness information, as people around the world are sharing their strategies for staying in the best of health. We are learning about lifestyle changes from one another, and potentially improving our health outcomes in the process.

Of course, all of this comes with a big caveat. Since it can be hard to tell which information on social media is truly evidence-based (and not misinformation), I always recommend evaluating any of the information you find online with a licensed health care professional.

There is good reason for this approach. In 2021, a systematic review of research into social media and health information indicated there was a great deal of misinformation about health online (this was especially the case on Twitter). In some of the examples reviewed across all types of social media by the researchers, up to 87 per cent of the data was incorrect.

Health care providers are privileged to have a formal education, and part of this training allows us to know what evidence-based research looks like, to decipher credible and non-credible information, and to understand placebo effects. We are trained in information safety.

I recently came across a viral trend on TikTok concerning a “raw carrot salad” recipe, which some users have recommended for easing menstrual issues. This simple salad contains a mixture of raw carrots, apple cider vinegar, coconut oil and salt. It claims to improve premenstrual symptoms such as acne, fatigue, brain fog, bloating and breast tenderness by lowering one’s level of excess estrogen. Some of my patients started eating this salad after watching videos about it on TikTok, and many thought their PMS symptoms had improved, prompting them to come in and discuss their hormones with me.

There are a few interesting health connections to make between the raw carrot salad recipe and PMS symptoms. The exact cause of PMS is unknown, but it happens right before the onset of menstruation, when a woman’s progesterone levels are highest and estrogen levels are lower (but still significant). If a woman has too much estrogen during the luteal phase of her cycle (the phase before her period), she may experience more intense PMS symptoms. Raw carrots can indeed help to reduce the amount of excess estrogen the intestine reabsorbs since they contain an abundance of non-absorbable fibre. This eases the liver’s workload and improves its metabolism of estrogen.

What the viral carrot salad recipe misses, however, is that cruciferous vegetables such as broccoli, cauliflower, kale, cabbage and bok choy help reduce excess estrogen even more than carrots do. These vegetables contain bioactive phytochemicals that also boost antioxidant activity, and have anti-cancer effects. Women with too much estrogen can benefit from at least two cups of these types of vegetables a day, especially two weeks before their period, to reduce PMS symptoms.

Estrogen dominance is an increasingly common problem among women and is associated with polycystic ovary syndrome, endometriosis, cysts, fibroids, estrogen-receptor-positive breast cancers, and uterine and ovarian cancers. But if you have symptoms of hormonal imbalances, TikTok and raw carrots are not a replacement for a medical evaluation. These viral trends are great for sparking conversations about health both in and outside of the doctor’s office, but these methods won’t be able to determine whether your hormones are actually imbalanced. That’s when it’s time to call the doctor.

Time will tell whether viral health trends will positively affect the well-being of my fellow millennials and Gen Z in the long term. Spectacular creativity and artistry are often involved in creating popular health care videos, which makes them easy to watch and sparks more online research and lifelong learning. People are now realizing at much younger ages that they must be pro-active in managing their own health; it is much easier to prevent a condition than to try to treat it after it sets in. Used wisely, TikTok and other social-media platforms could be instrumental in how we modulate our health and well-being into the future.

But whatever online advice you come across, please take these doctor’s orders to heart: It is always best to confirm what you learn online IRL, with a health care professional.

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