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I was told that I was a hypochondriac by a few doctors so I went away and studied what hypochondriacs typically complained about. I found that there isn't as m

I was told that I was a hypochondriac by a few doctors so I went away and studied what hypochondriacs typically complained about. I found that there isn't as much variety in complaints as you would expect if people were independently making things up to complain about and there isn't as much consistency as you would expect if the complaints were due to social contagion. There does seem to be spikes around general awareness like when a popular TikTok or famous person is diagnosed with a thing, but it's possible to use the less well known bucket of comorbidities to figure out what percentage of those are examples of social contagion, what percentage do present with these actual conditions, and what percentages are true hypochondriacs. The first group lack the depth of comorbidities that the second group have, and the true hypochondriacs tend to claim they have absolutely everything no matter how preposterous. From what I found the large majority of those considered hypochondriacs do exhibit the conditions that they believe they have. The social contagion and true hypochondriacs appear to cooccur with mental disorders and are only a small percentage of the cases. I really wish medicine made an effort to distinguish between these three cases to extract the apparent hypochondriacs from the true hypochondriacs and treat them separately. I think a large number of those with undiagnosed conditions actually exhibit conditions from the hEDS bucket of comorbidities which is especially vast and varied. See https://ohtwist.com/about-eds/comorbidities https://ohtwist.com/about-eds/comorbidities for an incomplete list. This bucket does include SIBO. So if you have been told by a doctor that you're a hypochondriac and you exhibit SIBO these do increase the probability of you having hEDS. There is an assumption that hEDS requires the person to exhibit excess flexibility and while this does appear to be generally true it doesn't appear to be a necessary condition. A person with hEDS, especially if they are male, may not exhibit any excess flexibility but will exhibit hEDS comorbidities at the exactly same rate as someone who has been officially diagnosed with hEDS which would be rather unlikely if they didn't have also have hEDS. Of course if a person exhibits excess flexibility that would increase their likelihood of having hEDS. What is very unorthodox about about my view is that this flexibility is not an essential component so a lack of flexibility is not sufficient to rule it out even if it does reduce the likelihood.

failrate 2y ago
Thank you for the well considered response, but my symptoms include a tremendous amount of flatulence and diarrhea, a specific smell that other people can detect, etc. that cannot be explained by hypochondria.
- cjbgkagh 2y ago
  I 100% believe that you are not a hypochondriac and did expect you to have corroborating evidence of such. I was writing in criticism your doctor’s initial assessment and of doctors in general. I was also throwing information over a wall on the off chance that the information would be useful to a third party that may not yet know about hEDS and hEDS related comorbidities.
haldujai 2y ago
> I think a large number of those with undiagnosed conditions actually exhibit conditions from the hEDS bucket of comorbidities which is especially vast and varied. See https://ohtwist.com/about-eds/comorbidities https://ohtwist.com/about-eds/comorbidities for an incomplete list. This bucket does include SIBO. So if you have been told by a doctor that you're a hypochondriac and you exhibit SIBO these do increase the probability of you having hEDS. Not really. SIBO prevalence increases with age and goes up to 80% in elderly patients. hEDS prevalence is between 0.005% and 0.02%. The symptoms/diseases you listed are very common. We don’t really use hypochondriac anymore but the reason these are common is because they’re vague constitutional symptoms that have 1000 different possible causes or nothing at all. > What is very unorthodox about about my view is that this flexibility is not an essential component so a lack of flexibility is not sufficient to rule it out even if it does reduce the likelihood. There is nothing unorthodox about this, it’s part of the 2017 international criteria for hEDS. https://www.ehlers-danlos.com/wp-content/uploads/2022/03/Malfait_et_al-2017-American_Journal_of_Medical_Genetics_Part_C__Seminars_in_Medical_Genetics.pdf https://www.ehlers-danlos.com/wp-content/uploads/2022/03/Mal...
- cjbgkagh 2y ago
  Well if the actual hEDS prevalence is a lot higher than that then it would upset a lot of your other numbers. The presumed prevalence of hEDS used to be 1/50K, then 1/15K, then 1/5K (you are here) and now more recent research has it 1/500 (post 2019). So I don’t take much stock in presumed prevalence given the history of it. What are the odds that they got it wrong all those other times yet completely right this time. The problem with first presuming this prevalence and then designing diagnostics around it is that of course the measured prevalence using these diagnostics will match the prior assumptions. I’m of the view that it’s ~1/50 (2%) depending on ethnicity and that >90% of these are rather mild and very difficult to detect yet still show up as comorbidities. I currently don’t have the evidence I would like for this theory, I do have enough for my own beliefs. Until I get my hands on enough relevant WGSs I will not have definitive proof.

failrate 2y ago

Thank you for the well considered response, but my symptoms include a tremendous amount of flatulence and diarrhea, a specific smell that other people can detect, etc. that cannot be explained by hypochondria.

cjbgkagh 2y ago
I 100% believe that you are not a hypochondriac and did expect you to have corroborating evidence of such. I was writing in criticism your doctor’s initial assessment and of doctors in general. I was also throwing information over a wall on the off chance that the information would be useful to a third party that may not yet know about hEDS and hEDS related comorbidities.

haldujai 2y ago

> I think a large number of those with undiagnosed conditions actually exhibit conditions from the hEDS bucket of comorbidities which is especially vast and varied. See https://ohtwist.com/about-eds/comorbidities https://ohtwist.com/about-eds/comorbidities for an incomplete list. This bucket does include SIBO. So if you have been told by a doctor that you're a hypochondriac and you exhibit SIBO these do increase the probability of you having hEDS. Not really. SIBO prevalence increases with age and goes up to 80% in elderly patients. hEDS prevalence is between 0.005% and 0.02%. The symptoms/diseases you listed are very common. We don’t really use hypochondriac anymore but the reason these are common is because they’re vague constitutional symptoms that have 1000 different possible causes or nothing at all. > What is very unorthodox about about my view is that this flexibility is not an essential component so a lack of flexibility is not sufficient to rule it out even if it does reduce the likelihood. There is nothing unorthodox about this, it’s part of the 2017 international criteria for hEDS. https://www.ehlers-danlos.com/wp-content/uploads/2022/03/Malfait_et_al-2017-American_Journal_of_Medical_Genetics_Part_C__Seminars_in_Medical_Genetics.pdf https://www.ehlers-danlos.com/wp-content/uploads/2022/03/Mal...

cjbgkagh 2y ago
Well if the actual hEDS prevalence is a lot higher than that then it would upset a lot of your other numbers. The presumed prevalence of hEDS used to be 1/50K, then 1/15K, then 1/5K (you are here) and now more recent research has it 1/500 (post 2019). So I don’t take much stock in presumed prevalence given the history of it. What are the odds that they got it wrong all those other times yet completely right this time. The problem with first presuming this prevalence and then designing diagnostics around it is that of course the measured prevalence using these diagnostics will match the prior assumptions. I’m of the view that it’s ~1/50 (2%) depending on ethnicity and that >90% of these are rather mild and very difficult to detect yet still show up as comorbidities. I currently don’t have the evidence I would like for this theory, I do have enough for my own beliefs. Until I get my hands on enough relevant WGSs I will not have definitive proof.