Evidence-based medicine has generated many philosophical and pragmatic challenges to clinical care. Chief among these challenges is how to deliver culturally appropriate individualized endocrine care while adhering to evidence-based guidelines and algorithms developed for large heterogeneous populations.
Since its inception, the American Association of Clinical Endocrinologists (AACE) has advocated for the finest in endocrine education and state-of-the-art health-care delivery without regard to race, ethnicity, gender, age, country of origin, economic status, lifestyle, sexual orientation or domestic living arrangements.

Off-label use and misuse of testosterone, GH, thyroid hormone, and adrenal supplements have become increasingly prevalent.