Last April the Endocrine Society hosted a meeting in Washington D.C. to discuss, what they considered, is the shoddy state of hormone testing.
I was reading about the hormone-measuring dilemma in the recent issue of Endocrine News (the Endocrine Society’s newsletter) and it got me thinking that it wasn’t too long ago that doctors considered the amount of hormones in the blood too small to quantify at all.
The ability to be measure hormones—that came about in the late 1950s—is in many way thanks to the Nobel Prize-winning Rosalyn Yalow.
Had she lived, Yalow would be celebrating her 95th birthday this week on July 19th. When she graduated from college and told her teachers that she wanted to be a scientist, they suggested she become a secretary for one. Good thing she didn’t listen. She only got into graduate school because so many men were off fighting in World War II, a few spots opened. As she would say later, “They had to have a war so I could get a PhD and a job in physics.”
She had trouble finding work even after graduating tops in her class but landed a position at the Bronx V.A. As legend has it, her first tiny laboratory had been a janitor’s closet.
It was at the V.A., where Yalow joined forces with Dr. Solomon Berson, and developed the radioimmunoassay, or RIA for short. RIA measures hormone concentrations down to the billionth of a gram. As Yalow’s biographer put it, that’s like measuring a teaspoon of salt tossed into the ocean. It’s also used to measure other things in the blood that had been considered unmeasureable, such as viruses and some kinds of drugs. (Berson didn’t get the Nobel because he had already died by the time it was awarded and Nobels are not given posthumously.)
These days we know that RIA works well for hormones that fall into a certain range, but it isn’t as good for hormones that are really scarce. The results also vary according to which brand is used. It’s like scales—we all know that some make us seem thinner than others.
For hormones, it wouldn’t matter so much each if each clinician relied on their own company’s standards for normal. But all too often, there’s one general chart with the window of normal values.
That means that a hormone test may suggest you are deficient in a hormone when you’re really not. And then you’ll be taking unnecessary treatment. And vice versa. You could think you have enough of a hormone when you could benefit from therapy.
For now, the Endocrine Society has gathered experts and formed PATH, which stands for Partnership for the Accurate Testing of Hormones. Their goal, as they put it, is to “advance the development of standardized hormone assays and advocate for the universal adoption of these assays in medical practice and research.” Which sounds like a sound idea.
I don’t think they intentionally announced their aims around Yalow’s birthday, but it seems to be good karma. A good time to remember a woman who fought against the odds to break down the all-male barriers—and at the same time revolutionize the field of endocrinology. I often loathe the overused word “revolutionize” when it comes to scientific achievements, but Yalow’s really was.
When she received her Nobel Prize in 1977, the committee said, “We are witnessing the birth of a new era of endocrinology, one that started with Yalow.”