A Five-Step Guide to Combating Misinformation on Social Media

How fear, profit, and cherry-picked data shape your feed—and what to do about it.

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I had a fantastic conversation with Prof. Tim Caulfield about his new book, The Certainty Illusion (highly recommend, you can find more info here), hosted by B.C. libraries (thank you!). You can listen to our conversation here.

We had a rousing discussion about misinformation, its vast impact on how we live our lives, and how medical misinformation has become partisan. Coincidentally, our discussion coincided with a tragic example–the cumulative effects of medical misinformation, conspiracy theories, and political weaponization, which resulted in the CDC advisory committee recommending against universal vaccination for hepatitis B at birth in the United States.

The science is so clear here. Universal vaccination at birth has reduced the number of children with hepatitis B by more than 99%. Before we started universal vaccination in the United States, there were about 18,000 children a year being infected with hepatitis B. It’s hard to think of a more effective public health program. Sigh.

Tim and I have both spent a long time thinking about misinformation and trying to combat it. If you don’t know, this has been a big academic focus of Tim’s. During our conversation, we discussed several ways to curate what you read and share on social media to help protect not just yourself, but everyone else. Instead of simply accepting defeat against what is currently feels like a tsunami, I want to share some takeaways from our conversation about how to stem the tide of medical misinformation on social media and in podcasts, which seem to be the primary ways it spreads. While most of us contribute to the misinformation ecosystem accidentally, that also means most of us can do our part to help stop or at least reduce it.

Tip #1: The Road to Misinformation is Paved with Supplements

Be careful about following or sharing content from people who profit from supplements. Tim and I were both in hearty agreement here.

In the United States, there is no faster, easier, or less-regulated way to make a profit in medicine than through supplements. I even set up a faux supplement company to show you how easy and profitable it is! Read about Dr. Jen’s Menopause Taming Turmeric Supplement here.

Selling a supplement or investing in a supplement company makes someone a wellness entrepreneur. I don’t care if they are also a doctor or have a Phd. The truth is, whether they like it or not, they are a wellness entrepreneur and are part of unregulated Big Supplement. And yes, that includes many big-name MDs and PhDs.

We need to acknowledge this, because financial incentives affect how doctors discuss medications with their patients and their prescribing, to the point that pharmaceutical companies have to report whether we doctors even receive a $12 lunch. Yes, even tiny incentives are effective. While we don’t have good data on nurses, registered dietitians, PhDs, etc. I think it’s fair to assume that it likely holds across the board.

Now think of all the hashtags for #AD and #Partner for supplements that you see on social media, which may bring some influencers hundreds of dollars and others tens of thousands. And then there are doctors and PhDs and anyone else who either sells their own supplements, have partnered with a company as a scientific advisor or to create what amounts to a product line, or are financial investors in supplement companies. How does this affect what they tell you about not just these products, but everything else? For some of these people there is a lot of money on the line.

I have two significant concerns from a misinformation standpoint when it comes to people who have financial entanglements with supplements.

Most supplements have little to no quality information to support their benefit or their safety, so to promote and/or sell these products, wellness entrepreneurs need to look past that inconvenience. If they are using low-quality data or are not providing any actual human data at all, to promote their supplement, where else are they light on facts? Seriously. In my opinion, accepting the cherry-picking of low-quality studies that is needed to support supplement sales is a slippery slope toward accepting low-quality data in general. When a telemedicine company is selling a supplement to provide “cortisol support,” or a doctor claims the turmeric they sell can “support” the immune system, or a doctor who is in investor in a supplement claims it is beneficial, they have lost all credibility for me.

The other issue is that wellness products are sold with fear. Here, I’m not just talking about the specific content wellness entrepreneurs make about their supplements; it bleeds over into much of their other content as well. Fear feeds social media algorithms better than any other fuel because we all gravitate toward it. If you want to build a following of 1 million or 10 million on social media or hook people into your podcast, you have to play to what sells: Fear that you will die or get dementia without menopause hormone therapy; Fear that if you can’t choke down 150 g of protein a day, you will get osteoporosis; Fear of visible signs of aging to sell estrogen face cream; Fear of aging to sell AG1 Greens. The list is endless. In addition, there may be an insinuation or even an outright false claim that medical guidelines are outdated, which borders on a conspiracy theory. There is a study that shows that the more conspiracy theories people believe, the more supplements they take, and the Alex Jones trial showed us that the more he leaned into the Sandy Hook conspiracy theory, the more supplement sales he made.

I even wrote about this fear-supplement ouroboros back in 2018, for the New York Times, in a piece called, “Worshiping the False Idols of Wellness.”

…to keep selling supplements and earthing mats and coffee enema kits and the other revenue-generating merchandise, you can’t just spark fear. You must constantly stoke its flames.

(Here is a gift link if it interests you.)

Fear builds the platform; the larger the platform, the greater the sales. The greater the sales, the more fear is needed. And throw some conspiracy theories in now and then for a rocket boost.

If you follow accounts of people who sell products, like supplements and weighted vests, and those who don’t, take some time to compare who uses fear and who doesn’t.

#2 Read Before You Share

Most of us don’t. According to research Tim discussed in his book, 75% of posts on Facebook are shared without being read, and this is likely similar across most social media platforms. The share button makes it so easy. I have definitely been guilty of that, especially from creators whom I trust. Hey, who had time to watch the whole video or read the whole post? But what if there is a mistake? And does this content really align with what I think, or am I sharing it to boost my own engagement? And what about the comment section? By sharing, am I promoting misinformation by way of the bot farm that has taken over?

If it’s important enough to share, then it’s important enough to watch the whole video or read the whole post. Especially considering how inflammatory some headlines are, because many times a headline suggests misinformation, while the article says something quite different and nuanced. In fact, in that situation, wouldn’t reading the article and sharing it with your own headline be better?

#3 Be Extra Mindful with Health Halos

Health halos are words we automatically associate with goodness, and there is a lot of overlap with the “appeal to nature” fallacy, as most of these words are associated with nature. These health halos create a concept, and even without explicitly stating that something is good for us, when we see or hear these words, our brains fill in the blanks with goodness. Just think how the word bioidentical has a lock on menopause hormone therapy, even though it is essentially meaningless (every pharmaceutical estradiol and progesterone must be bioidentical, in the same way that every bicycle must have two wheels).

Here are some words to keep an eye out for when reading content online or listening to podcasts. Tim explores each one in the book and backs it all with science (except plant-based; I added that because there is no actual definition, yet I hear it all the time in hormone therapy marketing).

• Natural

• Holistic

• Healthy

• Organic

• Chemical-free

• Toxin-free

• Immune-boosting

• Personalized

• Plant-based

If you find these words, it’s worth reassessing the content for accuracy. And if a creator is using them a lot, I’d why they are so dependent on marketing buzzwords. A doctor or any medical professional should be able to make engaging content without relying on health halos.

#4 Check the Scientific Consensus

It’s easy to be swayed by content on social media. It’s persuasive and influential! Hence, the very apt term, influencers. But in this age of misinformation, everything really needs a fact check. One of the best ways to do that is to see what the experts say in guidelines. Do they recommend this product or this test? There is usually consensus about many major things. For example, experts from multiple fields are universally upset about the CDC’s decision regarding the hepatitis vaccine at birth, and multiple medical professional organizations have come out with statements.

I see a variety of wellness entrepreneurs, including doctors, recommending prenatal vitamins containing methylfolate rather than folic acid. The medical consensus is that folic acid is the recommended product. So you, the consumer, need to consider whether to believe a person who has built a platform partly on recommending methylfolate outside the guidelines (very often with a referral link), or the people who have done the research and the experts who put the guidelines together, all of whom have disclosed their conflicts of interest? There are no two valid sides here. On one hand we have the body of quality evidence and on the other, it’s cherry-picked data.

If content is worth sharing, it’s worth finding out where it sits in the body of knowledge and what the experts think.

Tim shared how when questioned, a significant percentage of people think pediatricians don’t support vaccinations. However, a researcher in British Columbia found that 100% of pediatricians surveyed supported vaccines, and so created content to share so people could have access to that consensus. Sadly, false balance in the media and on social media is what creates the illusion that many pediatricians are on the fence about vaccines.

A good way to quickly find what the experts say is to Google the question plus the name of the medical professional society, such as ACOG (American College of OB/GYN), The Menopause Society, or American Academy of Pediatrics to name a few. Sadly, for me, the CDC is now off that list of references. I am thinking about creating a resource with all the links to all the medical professional societies that I find useful, and I would ask my colleagues in other fields as well for their recommendations. My hope is this would make it easier to search. Let me know if that would be helpful.

#5 Did the Post Make You Feel Like You Scored a Touchdown?

Tim introduced this concept in his book. It is advice from Professor Kate Starbird, who is an expert on social media and misinformation. However, hearing him actually say it out loud gave it even more weight. It’s a great way of summing up how polarized things have become, and it made me stop and think. The point of science isn’t to spike the football in someone’s face; it’s to advance knowledge and help people. A “Yeah, we won” attitude doesn’t really fit with that goal. When a medical post makes you feel like someone has racked up points on a scoreboard, it’s worth asking yourself, “How much of why this resonates with me is about ideology and echo chambers and self-identity, and how much is really about a win for science?” And I think it’s also fair to wonder why the hype. Is it to get attention? And is this really the win it’s made out to be?

This “touchdown” feeling put into words the discomfort I felt with many posts about the FDA decision on the black box warning for estrogen. I saw post after post on Instagram celebrating Dr. Makary, RFK Jr, and the FDA. To me, this was a false victory because it was associated with misinformation. In addition, while Makary was promoting this as proof that the administration was pro-women, I was getting emails from my patients about losing their health insurance due to the policies of this supposedly “pro-woman” administration. Gutting health insurance isn’t going to help more women get treatment for their menopause symptoms or afford their vaginal estrogen. The bigger picture is this was a tiny victory that came with the cost of spreading misinformation, and even worse, allowed a notably anti-women administration to get positive press to distract from all the other ways they are harming women (and society in general).

If a post really taps into your emotions in a “spike the football” kind of way, it’s time to pause and reflect on the content. I will definitely be taking this one to heart.

I do hope you have a chance to check out my conversation with Tim. Despite everything that is going on from a medical misinformation standpoint here in the United States, it was quite uplifting and there is a lot of content I didn’t cover. And Tim’s book is a great gift idea for anyone who spends anytime reading medical content online or listening to medical podcasts.