modern medicine

Modern Medicine, God Particles, and Ayn Rand. Oh My.

6899 views

Ever wonder why so many people are so sick with so many different chronic and debilitating conditions? I do. In fact, I think about it all the time. Much of the last several years have been spent interacting with individuals who are ill, sometimes desperately ill. For these individuals, modern medicine has failed and failed miserably. Indeed, many have been cast out of traditional medicine altogether, their illnesses deemed too complex to solve. For all its technical sophistication, modern medicine falls decidedly short when it comes to the complexity of functional illness. The disease processes that can emerge from a myriad of different variables, evoke complex and cascading metabolic reactions and require more than a magic pill, device or exquisitely executed surgery, flummox even the most capable physicians. It is easier to label those diseases psychogenic or psychosomatic and those patients as difficult – you know crazy.

What if these patients aren’t crazy? Or what if those behaviors colloquially deemed crazy, are really just the tip of the illness iceberg?  What if the seemingly unrelated, often unusual symptoms, even those that evoke symptoms of crazy – of psychosis, of unremitting and misplaced anxiety, of soul searing sadness and depression – what if those are simply symptoms of a greater illness? Absent trauma, psychiatric symptoms don’t simply emerge from nowhere. Are we missing something when we dissociate emotional, cognitive and other ‘psychological’ symptoms from the totality of what are perceived to be the organic diseases? You know the ones that we can see with our own eyes (aided by high tech imaging or microscopy, but seen nevertheless), or feel with our hands, or smell, or in some other manner, sensibly perceive – diseases that are real and material in nature.

While modern medicine has done wonders with acute and emergent care and is brilliant in its capacity to design and implement increasingly sophisticated technological innovations, it falls short in the face of the complexities of functional, non-linear, apparently non-material systems. The systems at the nexus of un-massed matter operating within a fluid and infinitely changeable medium that appear beyond our calculative perceptions and defy the hard and fast material compartments into which we so want them to fall. In medicine, we have yet to recognize that there are few simple and separately controllable cause/effect relationships. We have yet to realize that there are no silver bullets, no magic pills or surgical procedures able to stop a multi-layered feedforward cascade; especially since no one is looking.

Blame It on Ayn Rand

And no one is looking, not because we are limited by intellectual capacity – the Higgs Boson, for example, reminds us of what is possible intellectually when we appreciate the mystery of things. No, we are not limited by intellectual capacity, but by a pervading lack of interest. Medical science (and politics and economics) have been wrapped up for decades, it seems, in some warped notion of a physics-defying magical universe of Ayn Randian extremes where man is separate unto himself; where he is both totally in control of all things that matter (and of matter itself) and his pursuits are completely disconnected from any ill-effects his actions evoke.

Ayn Rand? Really, Chandler, you’re bringing in Ayn Rand? Yep. I cannot help but thinking that our ridiculously compartmentalized approach to modern medicine, the one that fails to recognize the connection between systems, that believes ever so strongly in its ability not only to perceive and know correctly the totality of human health and disease but to manipulate and control it without repercussions, without consequence, is an offshoot of Ayn Randian epistemology. You know, the one that suggests man is an end unto himself, that his happiness is his moral goal (the rest of us be damned) and that his reason is reality (no matter the evidence to the contrary). Yes, that Ayn Rand. Her notion of man’s undying and incontrovertible heroism paired the inviolate rightness of his reason pervades modern medicine; the hubris, the compartmentalization, and the seeming blindness to its own actions are cornerstone. What a wonderful position to hold in the universe, mini man-gods, always certain and always right. Certitude of reason paired with inculcate selfishness all but eliminates the possibility of any reality beyond what it already known and accepted.

Such a perspective would have pretty much squelched most of modern physics, including the search for the Higgs Boson, better known as the God (damn) particle (yes, that was the original moniker). Imagine medical science searching for something so esoteric and so beyond the linear, predictable, and visible equations we have now; something akin to the Higgs Boson (un-massed matter moving within some universal but changeable medium – a medium that dictates force and follows our calculations only if we can identify the mass of the item and the medium within which it operates – which we cannot). Human physiology is no less complex, but nevertheless, in our current Randian state of self-serving hubris, the complexity of human health is all but unimaginable. We have supplanted medical science with some warped construct of sciencism, bolstered by the safety of Randian hubris. And while morally endowed certainty feeds our egos, it does little to forward understanding or relieve suffering.

What if Medical Science Was More like Physics?

What if the pursuits of medical science were more like those of physics where complexity is embraced? Consider the concept explored by those searching for the Higgs Boson –  of unmassed matter. That is mind-blowing.  A notion upon which so many equations and assumptions about reality rest but one that is yet unproven. Contemplate “mass is constructed entirely from the energy of interactions involving naturally massless elementary particles…“. In both its literal and mathematical calculation we have an impossible dilemma of knowing something before it is known; of a ‘decision-point’ among an infinitude of decisions that determines a trajectory. I imagine it as trying to identify a  “universal but changeable medium (the soup of life)” – a medium that dictates force and follows our calculations only if we can identify the precise mass of the item (at the precise time of measurement, remembering of course that measurement itself changes trajectories and that the medium determines the mass) and in the ‘real’ (not the experimentally contrived) medium within which it operates. Sit with that for a moment. The medium within which we exist is infinitely variable and that variability influences the output and vice versa.  That goes well beyond any of current methods of medical experimentation (which, for all intents and purposes, are based upon basic crop science). In fact, infinite variability is the antithesis of medical science, especially the current inviolate rightness of the pharmaceutical model of medicine, where magic pills influence only their intended targets with nary a side effect or unintended reaction.

What would happen if we were to appreciate this level of complexity in modern medical perception?  What would happen if we were to address health and disease, not in nice little physiological compartments, but as one connected process that involves functional and metabolic adaptations at every level?  What if gut health or disease impacted brain health? What if your ovaries were connected to your thyroid? Or your testicles to your brain? (Oh wait, that connection has already been discovered.) What if we recognized the possibility that each system could talk, respond, and adapt to changes in other systems? And that each of those adaptations engendered ever-so-slightly different trajectories?  Is it possible that we are one, completely integrated organism and not simply a collection of compartmentalized organs? Oh, the blasphemy.

It seems too fantastical to be true; a human organism that contains within it a myriad of interleaving parts, with feedback and feed forward systems, adapting and changing functionally to ever-dynamic internal and external signals. At the very least, it contradicts generations of medical specialization, decades of codeable and billable efficiencies, and every human impetus to name, categorize and separate disease. Perhaps more importantly, a notion of a connected universe defies the Randian moral imperative of selfishness.

While it is entertaining to consider that each of us is an island unto ourselves and that our happiness is a moral imperative, it just doesn’t fit the reality of existence without a fair degree of cognitive dissonance. Alas, my friends, despite our efforts to the contrary, the human organism does not exist in bubble and neither do the component parts that make us human exist in isolation. We can no more dissociate our genetic history from our ancestral and current environments than our current health epidemics from the toxic cocktail most of us call food. Everything is connected to everything else. Every action evokes a reaction (and those actions change the very nature of possible and probable and are likewise affected by the constantly changing medium within which they develop). No, matter how much we would like calories to magically disappear or the lifetime of bad health choices to evaporate, the reality of organismal physiology includes a physics of connectivity and a long, long memory.  If medicine is to progress beyond the Randian magical thinking of separateness, it must move towards a more complex physics; one where actions not only have reactions (we don’t seem to consider even the most basic physics with medication reactions), but where our questions match the complexity of the Higgs Boson, and thus, the complexity of organismal interactivity.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

Image credit: CERN.

This article was published originally on Hormones Matter on December 9, 2015.

The Voice of Hippocrates

7732 views

The Hippocratic Oath, supposedly sworn to by all physicians when they graduate, is well known to contain the sentence “Thou shalt do no harm”. In spite of this, the “Table of iatrogenic deaths in the United States” (deaths induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedure) lists 106,000 cases of adverse drug reactions, 98,000 cases of medical error and 37,000 cases of unnecessary procedures. Neither is this the complete table. I came across a September 2018 issue of “Life Extension” that discussed the use of preventive nutrition as an emerging medical methodology. Perhaps the most arresting statement made in this issue concerned the fact that about 250,000 Americans die from sepsis each year and that a recent study has shown that intravenous treatment with vitamin C, hydrocortisone and vitamin B1 reduces sepsis mortality by 87%. A statement like that should make headlines but it is very likely that it will be confined to a few physicians by association, at least for some time. A December 2018 issue of the magazine “Discover” claimed that Alzheimer’s disease is under attack and describes “lifestyle plans that improve brain health”. Our new book, “Thiamine Deficiency Disease, Dysautonomia and High Calorie Malnutrition” presents many case records of patients with symptoms that haunt thousands of doctor offices in the United States. The early recognition of these common symptoms as evidence of nutritional deficiency may well be a key factor in the prevention of much more serious disease.

Perhaps a short case history may help the reader of this website to be aware of the rising importance of a relatively new branch of medicine known as “Alternative Complementary”, sometimes as “Integrative”. The use of these terms indicates that the development of scientific medicine has come a long way, but that it needs an extension. The best developments are in surgery, but the removal of a sick organ as a therapeutic measure surely must be an indication of medical failure. When I was in practice, I was a member of a group of physicians whose medical fraternity was known as the “American College for Advancement in Medicine” (ACAM). Like all innovations, it has had to struggle for survival. Another group of like-minded physicians is known as the “International College of Integrative Medicine” (ICIM). There is no doubt that this branch of medicine is growing. However, in my association with friends, the idea of using nutrients in the treatment of disease is completely foreign to them. They are understandably baffled by telling them that dizziness, heart palpitations, and even fainting attacks could often be relieved by taking a simple vitamin supplement.

Nutrients, Energy, and Health

I will tell the story of an eight-year-old girl who had a lifelong history of extremely severe asthma. She was so allergic that she could not use any form of mattress and in fact she had been sleeping on a plastic lawn chair for years because of this. When I performed a clinical examination, I noticed that her body was covered with “goose bumps”. A reader may or may not be conversant with this phenomenon and it is likely that few would have any knowledge of why this occurs.

To give you an idea of the treatment that I chose, I must provide a simple explanation. At one time, the human body was covered with hair and if an individual was confronted with a dangerous situation he would get a well-known reflex known as the “fight-or-flight”. Each hair grew out of a tiny cavity in the skin known as a hair follicle and a tiny muscle known as erector pili (Latin for hair raiser) would be activated by this reflex, raising each hair to an erect position. It was thought that this mechanism in primitive hominins, (forerunners of the human race) by raising all the body hairs, would make the individual look much more aggressive in the confrontation. Well, most people have very little hair on the body but we have retained both the follicles and the erector pili muscles. “Goose bumps” are caused by follicles standing up on the surface of the skin as a result of the muscle contraction, even without the presence of a hair growing from the follicle. Some people will remember that a frightening situation may be associated with a feeling of hair rising on the back of the neck, another marker of this primitive reflex. Therefore, this child’s asthma was associated with at least part of the fight-or-flight reflex, known to be activated by the nervous system known as autonomic (automatic).

Because of my knowledge concerning nutrients and their reactions, I knew that thiamine deficiency would not only activate this reflex unnecessarily, but that it could produce an imbalance in the autonomic system that could result in bronchial constriction. Since giving a water-soluble vitamin like thiamine in a large dose could do no harm, I thought that it was worth trying. She began 150 mg/day of thiamine hydrochloride, readily available at a health food store. During the next five months she experienced only two mild attacks of asthma and her body weight had increased by 6.4 Kg. When I examined her chest, there was no evidence of wheezing. This remarkable increase in weight was probably because her energy metabolism had accelerated as a result of the introduction of an important factor in its production. She had grown to the normal body weight that she would have had if she had not had energy deficiency. You can perceive that the diversity of clinical expression was explicable from the single entity of thiamin deficiency, not several distinct diseases with separate causes.

The Practice of Medicine

Several factors enter into discussing a treatment that was not only completely safe, but derived from medical school training. It required knowledge concerning energy production and the effect of malnutrition in the nervous control of the body organs. It depended on a simple clinical observation and knowledge of its underlying mechanism.

The “practice” of medicine must surely indicate that the physician’s knowledge is expected to grow with clinical observation and experience. Since the body is a biochemical machine that relies on appropriate fuel for healthy and normal function, knowledge of nutrition is an essential element that has been sorely neglected in the modern world. Physicians have to understand how nutrition is turned into energy and then used for function. The present practice of medicine for the primary physician is almost confined to listening to the pharmaceutical industry in the production of the latest drug. The time allowed for each patient is restricted and it is no wonder that physicians are becoming disenchanted, often retiring earlier than usual. Surely we should be trying to follow the example set by “the father of modern medicine” in 400 BCE.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

The Experiment: Notes from a Reluctant Lab Rat

3232 views

I’m not doing so well in my role as lab rat as of late. I’m expecting the powers that be will soon be calling me back on the carpet. I’m getting used to that. Being told to do one thing and then doing another never gets a hand clap from the overlords of medicine, so I’ve discovered.

It started with the multiple diagnosis’s a year after I was first put in the cage for the “experiment”.  I can remember it like it was yesterday. The pursed lips of disapproval and those side shifting eyes. I didn’t get it back then. I was too preoccupied with my devastation to notice. I see now how futile my efforts were in trying to assist them. That kind of behavior will get you a special label and believe me, their kind of special is not a pleasant one.

It’s hard adjusting to being in a cage after years of freedom. The overlords don’t seem to get that fact. For them it’s all numbers and weights and measures and instruments that poke and prod. There’s a lot of heading shaking and nodding and hands on chins while they observe my reactions and record my symptoms. I can see it in their eyes. The data is not adding up. They don’t know how to interpret what they are seeing but I remain silent….at first.

I’m busy adjusting…adapting to what has become my new prison. I’m busy in my head connecting dots. Still reeling from the shock of being caught. Still taking stock of the damage they have wrought on me with their potions and notions and endless pills. Each tentative step forward fraught with trepidation and my silent anger. Their white lab coats have become a symbol of their surrender to my angry eyes but as always they soldier on in the pursuit of science.

Marking and measuring symptomologies, feigning a knowingness I know they don’t possess. After all, isn’t that how I ended up here, on the weight of their duplicity?

I’m not alone in this cage but I’m alone in myself. I am beginning to understand that I am just one cog in an endless wheel that they have created. A Frankenrat, crippled and ever mutating under the power of their chemistry, as they silently observe. I can feel myself shrinking under their disapproving gaze but it’s only a momentary slip. I retreat inside myself. I become invisible, silent and still.

I watch the watchers…waiting for that perfect moment…that golden opportunity I know is coming. Every day is a new day I tell myself. Every day that I wake up and draw a breath is another day I have won. I may be a lab rat but I am no longer their lab rat. I dream of the day when all of the lab rat nation will rise up as one and our voices will be heard. That’s the beauty of experiments…one never really knows what the outcome will be.

We Need Your Help

Hormones Matter needs funding now. Our research funding was cut recently and because of our commitment to independent health research and journalism unbiased by commercial interests, we allow minimal advertising on the site. That means all funding must come from you, our readers. Don’t let Hormones Matter die.

Yes, I’d like to support Hormones Matter

This post was published originally December 1, 2015.

The Disease – Medication Model of Modern Medicine

25971 views

As we begin analyzing the data from our studies and I search for ways to quantify the value of our data, I am repeatedly struck by how the business of modern medicine, especially modern pharmaceutically based medicine, has been conceived of, constructed, and is evaluated on a false and outdated premise of separateness. The notion that a disease is a completely discrete entity, that the disease process is linear and that one medication or set of medications impacts only the specified disease, predominates. This is just not so. Life is complicated, disease is even more complicated, and with the exception of perhaps the outright physical trauma of a limb or the need for immediate decision-making in acute or emergent care, nothing is as simple as the one drug, one organ system perspective from which we measure modern healthcare.

As an example, data from our studies are showing complex clusters of adverse reactions that are multi-system and often evade existing diagnostic categories. The symptoms themselves appear to cluster in ways that are unique and will inevitably lead to a deeper understanding of medication reactions, and hopefully, illness itself. For now, however, they appear to defy the logic of current diagnostic categories. The symptoms never quite fit neatly into a single diagnostic box that defines the disease course or guides a treatment plan.

Instead, the symptoms fall into multiple and sometimes contradicting disease categories, and rather than drill down to an appropriate diagnosis, the individuals in our studies have been assigned a long laundry list of apparently, co-occurring diseases; none, accurately characterizing the scope of their illness. When one disease does not capture the full breadth of symptoms, the trend is to add another. If that doesn’t work and when the interaction between the medications creates more unexplainable symptoms, add yet another diagnosis or three or five. Soon the patient has many active diagnoses, with multiple medications to go with. One has to wonder, how so many individuals can have so many diseases at once. Since, I suspect the laws of probability, and indeed, human physiology are contrary to the current multi-disease trend, it leads me to believe that the western model of defining and treating illness, as anatomically and genetically discrete entities, has reached the limits of utility. A paradigm shift may be in order.

Paradigms, especially in medicine and science, are often guided by forces that determine the limits of what can be known, or more cynically, what are considered acceptable pursuits of knowledge and science versus the flights of fancy of fringe scientists. In this case, I would argue that the forces controlling what can be known are those who profit directly from the current diagnostic system – the pharmaceutical industry. The deeply entrenched conflicts of interest between these corporations, policy makers, regulators, politicians, academic institutions, academic journals, medical societies, patient organizations, media organizations – the very ‘thought leaders’ that determine what is valid and what is not – lends credence to these suspicions.

And by every measure, what is currently valid, are the simplistic and discrete categories, with easily identifiable lists of medications for each, where additional diagnoses equal more medication possibilities or in economic terms more product sales opportunities. Whether the symptoms within these disease categories overlap with each other or even represent a true disease process seems to have little bearing on whether a medication can be fit to match a certain set of symptoms and linked to a diagnostic billing code. The diagnostic billing code becomes at once the arbiter of defined diseases and of what can be known about a particular disease. If there is no billing code, read no product or medication opportunity, the disease doesn’t exist, but if there are multiple, overlapping disease categories, no matter how poorly defined or distant from what the patient may actually be experiencing, there is product opportunity, and therefore the disease, or more likely, the diseases he or she is experiencing, exist.  And, if the criteria for defining a particular disease can be relaxed to include more patients and to maximize prescribing opportunities, well then, that is even better.

Consider the most recent recommendation by the American Heart Association and the American College of Cardiology to reduce the risk level for heart attacks necessitating a need for increased prescriptions of statin drugs. The change in guidelines will mean more Americans will be diagnosed with heart disease necessitating prescriptions for the cholesterol lowering drugs, a boon to the drug industry. In a few years, epidemiologists and those who study healthcare trends will report a predictable increase in the number of Americans with heart disease, more money will be poured into preventing heart disease with more medications prescribed and so on. It’s a fantastic business model, control the definition of disease to control the market for products. Will more Americans have heart disease? Not likely, but changing the diagnostic criteria, changing the billing code, to open product markets will give illusion of increasing illness and this benefits the manufacturers of these products.

Unfortunately or fortunately, depending upon which side one is on, lowering the threshold for prescribing opportunities does more than simply increase the number of patients to be given a particular diagnosis, it opens up additional product markets or diagnostic opportunities when the side effects of the primary drug kick in and necessitate treatment. In women, for example, statins increase the risk of Type 2 diabetes. By lowering the criteria for diagnosing heart disease and prescribing statins to more patients, not only will we see an increase in the rates of heart disease in a few years, but because the research tabulating disease rates rely on the diagnostic billing codes, we will also see a corresponding increase in the rate of Type 2 diabetes, most likely created by the increased use of statins. Similarly, because the medication used to treat Type 2 diabetes elicits a corresponding reduction in vitamin B12 levels, which present as a heterogeneous set of neurocognitive symptoms, in a few years, we’ll also see an increased rate of mental health conditions indicated by the growing rates of psychotropic medication prescriptions. And so on.

To be both the arbiter of what is known and can be known, to control the definition of disease and the guidelines for prescribing, is a brilliant business model, but one that does nothing to improve human health, further medical discovery or scientific understanding. Indeed, the survival of this model relies entirely on maintaining the facade of anatomical separateness in disease processes and on not recognizing the totality of medication effects across an entire physiological system. This model relies on remaining ignorant of the inter-connectedness of disease processes and by association the possibility of broad based ‘complicated’ medication reactions.

If diseases remain separate entities and medications work only on specified disease targets, then disease categories remain entirely under the purview of those who stand to benefit from prescribing opportunities. Data that link the onset of a disease to the use of a medication or redefine the scope of a disease process and medication target beyond a specified anatomical region can be easily dismissed. And that is where I find myself, having collected data that questions the accuracy of the current model of anatomically discrete, one medication-one target model of disease. Our data question a paradigm. What does one do with that?

We Need Your Help

Hormones Matter needs funding now. Our research funding was cut recently and because of our commitment to independent health research and journalism unbiased by commercial interests we allow minimal advertising on the site. That means all funding must come from you, our readers. Don’t let Hormones Matter die.

Yes, I’d like to support Hormones Matter.

Image by Elisa from Pixabay.

This article was published originally on November 18, 2013. 

Thoughts on Inflammation, Vaccines and Modern Medicine

6510 views

One of the core components of an HPV vaccine adverse reaction inevitably includes some degree of seemingly unexplainable but observable brain inflammation and white matter disintegration. The brain inflammation falls under a number of different names and diagnoses, some are regionally specific, cerebellar anomalies for example, while others demarcate a more diffuse injury including, acute disseminated encephalomyelitis (ADEM), myalgic encephalomyelitis (ME), sometimes known as chronic fatigue, multiple sclerotic (MS) type lesions and, the newest and perhaps more prescient among them, a set of conditions designated as Autoimmune/Inflammatory Syndrome Induced by Adjuvants or ASIA that denote chronic inflammation both centrally and peripherally relative to vaccine adjuvant exposure.

Is the Brain Immune Privileged?

Despite the observance of brain inflammation in many post HPV vaccine victims, many practitioners, and indeed, the FDA and CDC, seem loathe to recognize that an aluminum lipopolysaccharide adjuvanted virus vector might induce a neuro-inflammatory response, leaving patients with little recourse post injury. The difficulties attributing brain inflammation to a vaccine reaction stem from a long held belief that the blood brain barrier is stalwart in its protection against peripheral trespassers.  The brain has long been considered, ‘immune privileged’ having little to no communication with peripheral immune function. Indeed, the perceived impenetrableness of the blood brain barrier is so extensive that brain-body separation might as well be complete, with a brain in bottle and a decapitated body.

Logically, we know this cannot be true. There must be crosstalk between the immune systems of brain/central nervous system and that of the body. How else could we survive if the two modalities were segregated so completely? It turns out, that logic may be prevailing. A decade of research suggests that the long held notion brain immune – privilege is completely and utterly incorrect. Indeed, the immune system not only guides early neurodevelopment (and so mom’s immune function matters) but communicates and affects brain morphological changes chronically. Likewise, signals from the brain continuously influence peripheral immune function.

The immune system appears to influence the nervous system during typical functioning and in disease. Chronic infection or severe illness may disrupt the balance of normal neural–immune cross-talk resulting in permanent structural changes in the brain during development, and/or contributing to pathology later in life. The diversity, promiscuity, and redundancy of “immune” signaling molecules allow for a complex coordination of activities and precise signaling pathways, fundamental to both the immune and nervous systems. 

It should not be surprising then, that nutrient status and toxicant exposures in the periphery, in the body, affect central nervous system function and are capable of inducing brain inflammation and vice versa. And yet, it is; perhaps even more so than any of us realize.

Re -Thinking Brain Inflammation

When one reads through the definitions, research and case reports of ADEM, ME, MS or other instances of brain inflammation, the notion that biochemical lesions in the periphery are linked to observed neuro-inflammatory reactions is far from center stage. Nevertheless, if we can accept the premise what happens in and to the body does not stay in the body, then we can begin to re-frame our approach to brain inflammation. Specifically, we can look at inflammation more globally and ask not only what triggers inflammation, but allows inflammation to persist chronically, regardless of its location. If there is an on-going peripheral inflammatory response, is it not prudent to suspect that a similar response might be occurring within the central nervous system, even if our imaging tools are not yet capable of visualizing the inflammation; even if it is too premature to observe demyelination, neuronal, axonal swelling or other telltale signs of chronic brain inflammation?  I think it is.

Vaccine Adjuvants: A Pathway to Brain Inflammation

With the HPV vaccine, and indeed, any vaccine, the deactivated viral vectors come with a cocktail of additional chemical toxicants and a metal adjuvant to boost the recipient’s immune response, as measured by the increase in post vaccine inflammatory markers. It is believed that without these adjuvants (and data back this up), the recipient’s immune response is insufficiently activated to merit ‘protection’ against the virus. The strength or size of the immune response is then equated with success and protection.

By this equation, an excessive immune response that continues chronically and is eventually labeled ‘autoimmune’ as innate systems begin to fail, is in some way not a failure or side effect, but an example of extreme success; the larger the immune response, the stronger the vaccine. And so, skewed as this observation may seem, within the current vaccine-paradigm there can be no ‘side-effects’, not really. By design, there should be inflammation, even brain inflammation; the more the better. Also by design, metal, lipid soluble, adjuvants cross the blood brain barrier and directly induce brain inflammation. To say vaccines don’t or somehow couldn’t induce brain inflammation is ignorant, if not, utterly negligent, and quite simply, defies logic. Again, for prudence and safety, shouldn’t we assume that an inflammatory reaction in the body might also ignite some concordant reaction in the central nervous system?

Why Aren’t We All Vaccine Injured?

What becomes apparent though, is even with exposure to the most toxic brew of vaccines, not all who receive vaccines are injured, at least observably. (I would argue, however, even those who appear healthy post vaccine, had we the tools to observe brain inflammation more accurately, would show a central inflammatory response, at least acutely, and likely, progressively). So what distinguishes those individuals who seem fine post vaccine, particularly post HPV vaccine, from those who are injured severely and sometimes mortally?

More and more, I think that the fundamental differences between vaccine reactors and non-reactors rest in microbial and mitochondrial health. Indeed, all vaccines, medications, and environmental toxicants damage mitochondria, often via multiple mechanisms, while altering microbial balance. Whether an individual can withstand those mitochondrial insults depends largely upon a balance struck among three variables: 1) heritable mitochondrial dysfunction, genetic and epigenetic; 2) the frequency and severity of toxicant exposures across the lifetime; and 3) nutrient status. Those variables then, through the mitochondria, influence the degree and chronicity of inflammation post vaccine. With the HPV vaccine in particular, the timing of the vaccine, just as puberty approaches and hormone systems come online, may confer additional and unrecognized risks to future reproductive health.

Mitochondria and Microbiota

The mitochondria, as we’ve written about on numerous occasions, control not only cellular energy, but cell life and death. Every cell in the body, including neurons in the brain, require healthy mitochondria to function appropriately. Healthy mitochondria are inextricably tied to nutrient concentrations, which demand not only dietary considerations but balanced gut microbiota. Gut bacteria synthesize essential nutrients from scratch and absorb and metabolize dietary nutrients that feed the mitochondria. Indeed, from an evolutionary perspective, mitochondria evolved from microbiota and formed the symbiotic relationship that regulate organismal health. Disturb gut bacteria and not only do we get an increase in pathogenic infections and chronic inflammation, but also, a consequent decrease in nutrient availability. This too can, by itself, damage mitochondria.

When the mitochondria are damaged, either by lack nutrients and/or toxicant exposure, they trigger cascades of biochemical reactions aimed at conserving energy and saving the cell for as long as reasonably possible. When survival is no longer possible, mitochondrial sequestration, and eventually, death ensue, often via necrosis rather than the more tightly regulated apoptosis. Where the mitochondria die, cells die, tissue dies and organ function becomes impaired. I should note, as steroid hormone production is a key function of mitochondria, hormone dysregulation, ovarian damage and reduced reproductive capacity may be specific marker of mitochondrial damage in young women.

Mitochondria and Inflammation

Mitochondria regulate immune system activation and inflammation and so inflammation is a sign of mitochondrial damage, even brain inflammation. Per a leading researcher in mitochondrial signaling:

The cell danger response (CDR) is the evolutionarily conserved metabolic response that protects cells and hosts from harm. It is triggered by encounters with chemical, physical, or biological threats that exceed the cellular capacity for homeostasis. The resulting metabolic mismatch between available resources and functional capacity produces a cascade of changes in cellular electron flow, oxygen consumption, redox, membrane fluidity, lipid dynamics, bioenergetics, carbon and sulfur resource allocation, protein folding and aggregation, vitamin availability, metal homeostasis, indole, pterin, 1-carbon and polyamine metabolism, and polymer formation.

The first wave of danger signals consists of the release of metabolic intermediates like ATP and ADP, Krebs cycle intermediates, oxygen, and reactive oxygen species (ROS), and is sustained by purinergic signaling.

After the danger has been eliminated or neutralized, a choreographed sequence of anti-inflammatory and regenerative pathways is activated to reverse the CDR and to heal.

When the CDR persists abnormally, whole body metabolism and the gut microbiome are disturbed, the collective performance of multiple organ systems is impaired, behavior is changed, and chronic disease results.

Reducing Inflammation

Instinctively, we think reducing inflammation pharmacologically, by blocking one of the many inflammatory pathways, is the preferred route of treatment. However, this may only add to the mitochondrial damage, further alter the balance of gut microbiota and ensure increased immune activation, while doing nothing to restore mitochondrial and microbial health. In emergent and acute cases, this may be warranted, where an immediate, albeit temporary, reduction in inflammation is required. The risk, however, is that short term gains in reduced inflammation are overridden by additional mitochondrial damage and increased risk of chronic and/or progressive inflammation. The whole process risks becoming a medical game of whack-a-mole; a boon to pharmaceutical sales, but devastating to those who live with the pain of a long-standing inflammatory condition.

In light of the the fact that damaged mitochondria activate inflammatory pathways and that vaccines, medications and environmental toxicants induce mitochondrial damage, perhaps we ought to begin looking at restoring gut microbial health and overall mitochondrial functioning. And as an aside, perhaps we ought to look at persistent inflammation not as an autoinflammatory reaction, but for what is it, an indication of on-going mitochondrial dysfunction.

We Need Your Help

Hormones Matter needs funding now. Our research funding was cut recently and because of our commitment to independent health research and journalism unbiased by commercial interests we allow minimal advertising on the site. That means all funding must come from you, our readers. Don’t let Hormones Matter die.

Yes, I’d like to support Hormones Matter.

Image by Pavlo from Pixabay.

This post was published originally on Hormones Matter on September 22, 2014.

A Patient’s Perspective on Modern Hospital Care

1637 views

I practiced the medical approach known as Alternative Complementary Medicine. I have tried to describe the reasons for the huge change in concept by referring to it as a “Paradigm Shift”. It is, in a sense, “back to the future” by noting the teachings of Hippocrates, the so-called Father of Modern Medicine.

The Grim Reaper eventually takes his toll. Many of us “fall apart” bit by bit as oxidative metabolism gradually becomes less efficient. Thus cardiovascular disease, cancer and other degenerative diseases become more common as we age. This is a little like the gradual rusting of automobiles with age. Rusting is oxidation of metal. The important point to make is that the preventive approach, through nutrition and other Alternative approaches, is better and safer than the present use of increasingly dangerous drugs. But no treatment ever invented is perfect, for perfection is an impossible attainment.

So how does a patient fare if a cardiovascular crisis event occurs in the senior years? What if a 911 call goes out and the patient is taken to the nearest emergency room and is admitted to a hospital? The orthodox modern therapy becomes a mandate. But the major problem is that the emergency room physician, the cardiologist and indeed all the modern specialists have not accepted that the preventive approach usually provides many years of total disease freedom. Because of the present public attitude towards taking medication, perhaps the art of taking nutrient pills might be encouraged, together with nutritional advice and education. It is not very sensible to say that prevention is a failure when a crisis disease occurs in an octogenarian. One might say that such a person has “beaten the game of life”. Could that person have succumbed to the same crisis disease 20 years previously? Of course she could. The evidence is that the date of death is written in the genome of each one of us. We cannot lengthen it but we can surely shorten it and that is the current method of lifestyle that does just that. The major point that I want to make is that the early years should be spent in obeying the rules of life that are set in the Great Design offered by Mother Nature. But the possibility of crisis disease looms in the declining years and modern medicine needs to do its best to stave that off as long as possible. That is why increasing recognition is being given to the idea of Complementary Alternative (or Integrated) Medicine, a concept that seeks to bring the high tech, life-saving procedure and the preventive approach together.

When Medicine Becomes Big Business

This was brought home to me when my 82-year old wife had a non-lethal heart attack. It involved a 911 call, transport to the nearest hospital emergency room and admission for angioplasty. There is no doubt that this intervention was a life-saving procedure. My comments from here relate to our personal experience. As most Canadians know, hospital stays in the U.S. are governed by directives known as Diagnosis Related Groups (DRGs), a method  of classifying disease in terms of expected hospital stay and reimbursement. The acceptable time limits for remaining in a hospital are proscribed by government rules. This results in premature discharge from the hospital in some situations. Because of complications that were avoidable under proper surveillance, the premature discharges for my wife resulted in two further admissions to hospital involving emergency surgery.

Aside from this, where one might argue that complications of this nature are part of any crisis illness, I really want to comment on the perspective of a patient and the family in a modern hospital. First, the nursing was appallingly deficient. To try to summon a nurse for help was a joke and it would seem mandatory in the present hospital setting for the patient to have a family member present as much as possible. Yes, nurses are in short supply.

Healing Requires Peace and Quiet

Perhaps the worst thing that must inevitably have a slowing effect on the healing process is the noise at night. Monitoring bells ring, crashes and bangs of obscure origin occur and the constant chatter of attendant personnel prevents sleep constantly throughout the night. For a group of nurses to stand outside a patient’s room and discuss their respective boy friends and husbands in loud voices, as though they are at a party, is unforgivable. The visit of the doctor in charge is brief, coldly business related and virtually non-communicative. The patient and family visitors are left almost completely in ignorance of what is being done and the reasons for the various studies and procedures.

There is little doubt that at least some of the behavior of physicians today is because they are all practicing defensively. The “least said the best mended” formula rides high on their agenda. The prospect of a lawsuit hangs over virtually any procedure.

It is worth commenting on the hospital night setting when I was a student and as a resident. Patients in an English hospital were placed in large rooms called wards that would contain as many as 20-30 beds. The only thing that could provide any privacy was a curtain that could be pulled completely around each bed. The night nurse sat at a desk just inside the entrance to the ward and even the light that she used was shaded. There was complete silence throughout the ward and absolutely no lights were allowed after “lights out” call. The nurse could be summoned easily by any patient under her watchful eye. There were no monitors or electronic gadgets to distract her and her authority was gentle, kind, but absolute.

Beyond Technology

The modern concept is that technology is the master mind of nursing care and it is unusual not to find personnel sitting in front of a computer monitor. The personal touch that is so important in providing communication to patients had simply disappeared. Disease has actually become dollar driven big business and patients (heaven knows, patience has to be infinite!) have become numbers almost like items on a conveyor belt that propels the patient through the technologically controlled system.

As a physician, I cannot imagine practicing medicine like this. As a husband, watching my wife suffer needlessly for no other reason than a failed business model that values technology and efficiency over an atmosphere to encourage healing, was repugnant.

Physicians, nurses and health workers in general need to apply themselves to learning about the plentiful science surrounding disease prevention. As long as Big Pharma rules the roost that provides their enormous financial profits, things will only get worse. I can only see change as it comes from the collective demands of the consumer, the potential patients. It will never come from the medical profession until the public demands it and this will take a long time to soak in. The public needs to speak out.

Listening to Patients – A New Opportunity for Medical Science

3440 views

Over the last several weeks I have been struck by the growing chasms in modern medicine. I see battles between physicians and patients, physicians and technology, physicians and bureaucracy and between the entire healthcare industry and health itself. The chasms are particularly deep in women’s health where so often serious health issues are written off as psychosomatic or with medication safety and efficacy where obvious side-effects are routinely discounted as not possible despite clinical and biochemical evidence to the contrary. Why is the physician not listening to patients? Why is he so quick to discount their suffering and attribute it elsewhere?

And then it occurred to me, within the doctor-patient relationship there has never been an impetus for the physician to listen to patients. The structure of modern medicine was built upon a presumption of physician authority and expertise that involved not listening but seeing. So what began as a post about listening to patients versus patient engagement (what the heck does patient engagement mean anyway), has evolved into a commentary on the eroding power of the physician and medical science in modern healthcare. Interestingly enough, I think the changes in modern medicine may finally permit, if not demand, listening to patients. Let me explain.

Listening to Patients: A Lost Art that Never Was

Historically, listening to patients has had, at best, a tenuous position in medicine. Some would argue that it was supplanted long ago by the physician’s all-knowing clinical gaze. The clinical gaze, a term used by French philosopher, Michel Foucault, is the ability to see correctly what is unseen, to bring to light and then describe the hidden truth of disease. It was what allowed the physician to penetrate the illusions of the non-scientific engendered by previous generations (16th – 18th century medicine) and to see the truth of the disease by correctly perceiving the signs and symptoms. The physician’s power of observation, his clinical gaze, aided by technology, gave him a vantage point inaccessible by mere mortals, and thus, incontrovertible.

The clinical gaze anchored modern medicine in a way that no other concept could. It brought with it the power to see truth, but also, to define it. No matter how potentially relevant to disease diagnosis, the patient’s truth or story could never replace the physician’s truth – the truth that was accessible only by him and through the all-knowing clinical gaze.

And so it was for most of the last century and a half, the physician was the arbiter of what was valid, of what could be seen and of what could be known about health and disease.  The patient was no more than a body; living or dead, it did not matter. It was the job of the physician to perceive correctly what the body (not necessarily the patient) was showing him and then classify, communicate, and finally, treat appropriately.

From Medicine to Healthcare and the Physician’s Diminishing Autonomy

Despite the inherent tension between the patient’s experience of his or her disease and the physician’s discovery and classification of that disease, the interaction was private, between the physician and the patient. The degree to which the physician listened or did not listen to the patient, the correctness of the physician’s diagnosis and subsequent treatment decisions occurred within the confines of his practice. So long as the interaction was private, the physician remained the arbiter of disease; the clinical gaze his power and the patient his subject.

When the private became public, gradually at first (third party payer systems, pharmaceutical marketing) and then explosively, (the Internet), the clinical gaze, the lens through which disease was defined, refocused away from the patient and the disease itself and toward the economics.

The Interlopers

Managed care and third party payer systems unlocked the sacred space between the physician and the patient. The economics of his treatment decisions increasingly bore more weight than the accuracy or the clinical outcomes. The economic principles of the new managed care systems were skewed divergently. On the one hand, managed care demanded efficiencies of scale in the allotment of care – more patients, less time – but on the other hand, and simultaneously, rewarded physicians and other healthcare providers with fees for services instead of positive outcomes efficiently managed. The macroeconomic principles guiding healthcare decision-making, skewed and untenable as they were, gave the physician a modicum of authority. Even though managed care infiltrated every aspect of the doctor-patient relationship, it was still the physician who defined the disease. The clinical gaze remained somewhat intact.

That was until the pharmaceutical industry caught on and the definition of disease not only miraculously began to fit the latest, greatest drug, but also fit managed care payer guidelines. Some would argue that late 20th century diseases and discovery emerged, not from the plight of human suffering, and certainly not from the powers of observation that once guided the physician’s clinical gaze, but by profit.

The physician, who at once held the power to see and define medical science, is now buried beneath a heap of competing and conflicting interests that are only cursorily related to the practice of medicine. There is no clinical gaze; no medical decision-making that rests solely upon his shoulders or within the space of the doctor-patient encounter.

And Then Came the Internet

The same technological advancements of the latter half of the 20th century that allowed the physician to see more, also allowed others to see what he was seeing and to communicate those insights broadly. Once that private and controlled perception became public, the physician and the all-knowing clinical gaze, no longer wielded the same power it once did.

The primacy and indeed the privacy of what was once a sacred relationship between the doctor and the patient, was overrun by a ‘system’ of disease economics; one that no longer can be considered medicine, healthcare or even what those in those in anti-modern medicine movement call disease care. Instead, we have a ‘health’ economics built on a false precipice of industrialized, factory, efficiency and underlain with a bastardized model of free market capitalism – moral hazard. Indeed, the creative billing seen in the healthcare industry makes the financial derivatives scandals of recent history look downright tame by comparison.

Business Innovation Disguised as Medical Innovation

Nowhere in the current model is there room for listening to patients, for relationship, for health, for ethics or even for medicine itself. Arguably, the possibility for medical discovery, the kind that breaks paradigms and catapults the science forward, is also stifled in favor high profit blockbusters that are no more effective than the last one, gadgets that often fail to deliver measurable improvements in care but sure are fun to play with, and ever intrusive services that make healthcare more cost-effective – well, not really.

Business innovations designed to enhance spread sheets and enhance patient engagement do neither. Indeed, patient engagement is no more than a meaningless euphemism for medication compliance. If we can only engage the patient more effectively through this application or that, then we will ________ (insert promise), save healthcare, reduce costs, reduce hospital visits, save time. What patient engagement applications are really promising is to save the world from the pitifully unengaged or disengaged, burdensome, non-compliant patient. There is no doctor-patient relationship and can be no relationship within this model. Both the doctor and the patient are cogs.

From this perspective, it is no wonder that physicians lash out against patient empowerment, against electronic health records and other healthcare innovation.  Each is a very real threat to an already diminished autonomy.

From Healthcare Back to Medicine: Listening to Patients Revisited

In spite of all the negatives of the entrenched medical-industrial complex (I hate that phrase, but it seems appropriate), there is hope. It rests not with ‘healthcare innovation’ that inevitably promises high returns, nor does it rest with the next great blockbuster drug. Rather, the survival of medical science rests within the space of the doctor-patient relationship. It is there, that when disengaged from the multitudes of competing interests, within that private moment, that the physician can unlock the next phase of medicine, the next great discoveries. It is there that he can listen to his patients.

The Necessary End of the Clinical Gaze

The clinical gaze as a power structure served its purpose in catapulting medicine from mystery and myth, but it was one-sided. It considered disease from an idiosyncratic lens solely within the physician’s control. This was both its strength and its downfall. Without feedback or resistance, it was easy for managed care and the pharmaceutical industry to invade this space and usurp the physician’s authority. All that was necessary was to learn the taxonomies and then redefine them to fit the economic needs of the vendors. New diseases, new drugs were viewed as medical advancements. Technology that standardized diagnostic criteria (or arguably loosened it so that most conditions would fit easily within many payer accepted categories), all but eliminated the need for the physician’s skills.

Had the internet not come along and opened the communication channels among patients, no one would be the wiser. With the internet, patients have become empowered and are rather loudly proclaiming their stake in this conversation. Patients search Dr. Google for diagnostic and treatment options, some sound, some not. They have formed groups and societies geared toward furthering education, research and strengthening their voices. Physicians have hereto ignored or chastised patients, lashing out against their new found empowerment, as if it were the patients and not the industry vendors, who displaced his vaulted position and redefined his diagnostic capabilities. No, it was not the patients who did this, but it is the patients who offer the physician a way back towards medical science – not the all-knowing, indisputable medical science of yesteryear, but the dynamic relational medical science of the next generation.

Listening to Patients as a Way Forward

Listening to patients provides the context and connections that can move medicine beyond an outdated and thoroughly usurped taxonomy of signs and symptoms that serves only to name and to limit or contain disease within an appropriately defined diagnostic category, to a space that can connect the larger patterns and the associations among diseases, health and environment. Physicians can lead this charge but only if and when they begin listening to their patients. It is the patients, not the industry, that hold the keys to the myriad of intractable diseases that plague modernity. Listening to patients, not patient engagement, but listening and trusting the truth of the patient’s experience of his or her disease, is the missing piece of the next great medical revolution.

This article was published previously in May 2013.

Navigating Invisible Illness in the Age of Modern Medicine

2207 views

Much has been about said about empowering and educating patients to be partners in the healthcare dance. From the e-patient and e-health revolutions through the piles of research showing more engaged patients have better outcomes, all seem to point a more active role and increased responsibility for the patient in his or her own care. But how does that work when the illness is not clearly defined, is not easily diagnosed or for which effective treatments are limited? What does it mean to be an empowered patient with an invisible illness?

This is the question that many women face on a regular basis. Indeed, for a number of predominantly female disorders, whether hormonally modulated or not, there are often many years before the symptoms are addressed as real and not figments of the female imagination. Chronic fatigue and fibromyalgia are two such examples, but so are endometriosis and an array of other perhaps more subtle hormone conditions.

During those years before modern medicine and the research community recognize the reality that define a particular disease process; during the years when women are prescribed psychiatric meds for non psychiatric conditions; during the years when pain medications with diverse side-effect profiles blur the line between the original disease and the one that is induced pharmacologically; during those years, how does one become the e-patient, the e-woman, without becoming a physician herself?

Really, we want to know.
Keep Reading