Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The Hollow Men of Hims

alexkesin.com

Post reply on HN
Print view View original

91–100 of 277 posts

Re: The Hollow Men of Hims

#91

Post by PaulHoule »

jackdeansmith wrote: post #7

>The real tragedy is not that Hims exists, but that it works so perfectly. Every day, thousands of people choose their compounded weight-loss drugs over FDA-approved alternatives, their combination ED pills over established single-ingredient treatments, their algorithmic consultations over actual medical care. They make these choices not because the products are better, but because the entire experience has been opti…

Really? I wanted to try Cialis, primarily for my enlarged prostrate but also for the erection effects. I asked my primary care doctor, that was a $20 copayment, I fill it my local pharmacy and it costs about a $5 copayment for a month’s supply. It’s a big practice where I might have to wait a long time if I want to see the head doctor but if I don’t care who I see I can usually get in pretty quick and they do a good job of keeping notes so care is well coordinated.

Some of it is that there’s a general breakdown in trust that makes a lot of people think that somebody who shot a healthcare executive is a hero, or that there is little outrage that a lunatic like RFK jr is in charge of HHS. I mean, there are legitimate reasons to think institutions are illegitimate but I think there’s something self-perpetuating about distrust, people find meaning in it. It reminds me of the 1980s and 1990s when there were all the stories right out of Rambo that there were still POW in Vietnam and you’d see those black flags everywhere because it wasn’t patriotic enough to fly an American flag.

Re: The Hollow Men of Hims

#92

Post by [deleted] »

turnsout wrote: post #68
kragen wrote: post #47

Earlier quoted context omitted.

An oligopoly colluding to push the price of easily produced products into the stratosphere isn't a product of deregulation . In a deregulated or under-regulated market, thousands of cottage-industry insulin producers would be competing to shave pennies off the prices of their insulin. You might have a hard time finding safely produced insulin, but you wouldn't have a hard time finding cheap insulin. Oligopolies collu…

This is a complex picture, so there's much more going on here than Big Pharma trying to squeeze out white-knight compounding pharmacies and supplement makers. What we have in the US is an industry that is constantly at the brink of system collapse, because that's the point of maximum efficiency/optimization. Pharma charges whatever payers (insurance companies) will support, and payers pass on whatever consumers can b…

[deleted]

Re: The Hollow Men of Hims

#93

Post by cjbgkagh »

hunter-gatherer wrote: post #62
cjbgkagh wrote: post #54

Earlier quoted context omitted.

I owe my health to gray market peptides, and for that reason and others I’m very happy they are available. Also recombinant DNA processes for making these meds is pretty mature tech it’s not like some crazy trade secret.

Can you expound on your use of peptides? My nephew was diagnised with crohns at the age of 10, but they now figure he was being mistreated when symptoms started at age 4. He is somehow still alive, but there have been significant developmental problems due to crohns and an overuse of steroids and other weird medications in his treatments. His parents have been doing IV infusions for the past two years, which seem to…

Sorry to hear that, my heart goes out to him. I post a lot about it here on HN, you can scroll through my prior posts, about half are on this. Also feel free to email me. Chrons is pretty common in people with hEDS, which is what I have, so while I don't have direct experience with having it myself I do know quite a few people who have had it.

Edit: had to do a quick double check, but the foods that I eat, and don't eat, are specifically for hEDS/ME/CFS brain fog which I believe is IL-1B cytokine related and I think it's plausible that this probably has a crossover to Crohn's. Listing it here as something to consider; A diet of zero sugar and zero fruit, a lot of kale, chia seeds, and pumpkin seeds. I do one meal a day, and an occasional extended water fast. For vitamins I take TUDCA, DIM, and D3.

Prolonged use of steroids can cause dysautonomia which causes a plethora of other issues. So understanding dysautonomia could help. I also use a weak ligand approach to dysautonomia which is unusual with the use of modafinil and amitriptyline.

Low Dose Naltrexone (LDN) is a rather benign medication that's been known to help. There is little downside to trying it - so it can be used as a bit of a diagnostic in addition to treatment. Of course DIY research rules apply.

One of my more out there theories that seems to be quickly gaining traction is that a low dose of GLP-1 agonists can be surprisingly good for autoimmune conditions.

Most of my other peptides are hEDS focused and include VIP, Ipamorelin, Selank/Semax, and BPc157/TB500. Though I really only take the ipamorelin and semaglutide these days. These are a bit more risky but since my alternative is to be very sick I have a different risk tolerance profile compared to most.

Re: The Hollow Men of Hims

#94

Post by digianarchist »

parpfish wrote: post #30

> The genius of Hims lies in understanding that consumers will pay almost any premium to avoid the humiliation of discussing erectile dysfunction or hair loss with an actual human being. Does the telemedicine appeal to people because they want to avoid embarrassment, or because they know that traditional doctors will schedule you for an appointment three months out just to say “have you tried getting better sleep, lo…

My Kaiser doctor recommended Hims for finasteride.

Re: The Hollow Men of Hims

#95

Post by sarchertech »

lmm wrote: post #76
sarchertech wrote: post #29

Earlier quoted context omitted.

Take the case of a antibiotics. A large percentage of people want their doctor to prescribe them antibiotics when they have a virus. It’s been shown that doctors who over-prescribe antibiotics get better patient reviews for example. Now you have a “better UX” that pops up that gives people exactly what they want. They answer a few questions on a website and they get an antibiotic prescription. There is no way for the…

> It’s been shown that doctors who over-prescribe antibiotics get better patient reviews for example. Are they over-prescribing, or are the others under-prescribing? Comparing how hard it is to get antibiotics as a human with how easy it is to get them for animals (even if there's no evidence of disease) certainly makes one think.

Antibiotic overuse in animals is a problem. It was recently banned for use as a growth promoter however, and use in animals is inherently less likely to lead to human infectious drug resistant bacteria.

And none of that has any impact on whether or not we should limit antibiotic overuse in humans.

Doctors certainly aren’t under-prescribing antibiotics if you look at the data.

Re: The Hollow Men of Hims

#97

Post by throwaway2037 »

jeremy151 wrote: post #52
jackdeansmith wrote: post #7

>The real tragedy is not that Hims exists, but that it works so perfectly. Every day, thousands of people choose their compounded weight-loss drugs over FDA-approved alternatives, their combination ED pills over established single-ingredient treatments, their algorithmic consultations over actual medical care. They make these choices not because the products are better, but because the entire experience has been opti…

> If you want safe and really high quality medical care you should absolutely have a personal physician you have a personal relationship with, who understands your lifestyle, your risk factors for side effects, and your medical needs deeply. How many Americans have that? Maybe a few dozen? A bit of a tangent: I have this here in the US, through a model called Direct Primary Care. I pay $50/mo for a single provider, u…

    > I do worry that it's sustainable
What is the maximum price that you are willing to pay?

Re: The Hollow Men of Hims

#98

Post by culopatin »

PaulHoule wrote: post #91
jackdeansmith wrote: post #7

>The real tragedy is not that Hims exists, but that it works so perfectly. Every day, thousands of people choose their compounded weight-loss drugs over FDA-approved alternatives, their combination ED pills over established single-ingredient treatments, their algorithmic consultations over actual medical care. They make these choices not because the products are better, but because the entire experience has been opti…

Really? I wanted to try Cialis, primarily for my enlarged prostrate but also for the erection effects. I asked my primary care doctor, that was a $20 copayment, I fill it my local pharmacy and it costs about a $5 copayment for a month’s supply. It’s a big practice where I might have to wait a long time if I want to see the head doctor but if I don’t care who I see I can usually get in pretty quick and they do a good…

Good for you but if you think your anecdote is the case for everyone you need to leave your personal bubble and talk to people

Re: The Hollow Men of Hims

#99

Post by zackify »

jackdeansmith wrote: post #7

>The real tragedy is not that Hims exists, but that it works so perfectly. Every day, thousands of people choose their compounded weight-loss drugs over FDA-approved alternatives, their combination ED pills over established single-ingredient treatments, their algorithmic consultations over actual medical care. They make these choices not because the products are better, but because the entire experience has been opti…

Literally the only reason I would use them is price. Cannot get anything for the prices they offer at a normal place or through insurance

Re: The Hollow Men of Hims

#100

Post by smileysteve »

classichasclass wrote: post #46
wonderwonder wrote: post #25

Hims is actually very expensive. I get the same Semaglutide for far cheaper either via my hormone dr. (provides a small, reliable dose of testosterone (trt) every month and legit access to hard to get compounds via a compounding pharmacy. No hoop jumping, they have a menu, I order from it. In real life I take 2 - 3x the testosterone dose when I am on but when I am coasting its easy no stress way to get what I want de…

Counterexample: what about antibiotics? There are negative externalities to their inappropriate use (yes, there are plenty of stories about the infections that were missed, but that has a lot of selection bias). There are countries that allow their use over the counter. Is that a good thing?

But antibiotics in the US are still over prescribed by doctors. There really are few cases for them for the mostly healthy adult; and they wreak havoc on your microbiome for what we're finding out is years. I know many people who will get antibiotics prescribed when they have a common cold (mostly a virus).

They're also under prescribed for things like appendicitis.

Post reply on HN