Is Disease Real?

 

Much of conventional medicine's advances required the foundation of standardized diagnoses and therapies. However, this approach assumes standardized patients which, since each individual is physiologically unique, leads to inconsistent clinical results and a high incidence of adverse drug reactions. The personalization achievable through genomic testing was advanced as a partial solution.

 

Another problem inherent in this approach is its disease-treatment orientation, thus the topic of this article: Is Disease Real? This title is intentionally provocative. Obviously, infectious diseases such as streptococcal pneumonia are real as are broken bones and IDDM (insulin dependent diabetes mellitus). IDDM describes high blood sugar levels due to a specific pathology - the loss of islet cells of the pancreas resulting in high blood sugar levels. But consider NIDDM (non-insulin dependent diabetes mellitus). It also indicates high blood sugar levels, but no specific pathology or physiological dysfunction. The elevated blood sugar levels may be due to inadequate secretion of insulin, insensitive insulin receptor sites on cells, lack of glucose tolerance factor, inadequate cell signaling, etc. While the high blood sugar is identified, the naming process may actually inhibit developing a curative approach to the patient. How about atherosclerosis? Yes, it does describe a pathological process in the arteries, but how did it happen and what keeps the pathology going? As Ornish and others have shown, the supposed end-stage arterial pathology is reversible.

 

The standardized diagnosis, standardized therapy, standardized patient approach works very well for real diseases - the use of antibiotics for bacterial pneumonia (assuming the patient's detoxification pathways are adequate for the drug used and that an underlying immune dysfunction was not missed) is clearly curative. However, for diseases which are basically convenient names for end-stage pathology, this approach provides little more than symptom relief and can obfuscate the actual physiological dysfunction. This symptom-relief approach typically does little to address the actual causes of the disease, thus the high, and growing, incidence of chronic degenerative disease.

 

Inherent in the disease naming approach is a fundamental loss of patient individualization. This loss of recognition of patient uniqueness is further aggravated by using the gold standard of conventional medical research - the randomized controlled trial (RCT) - to evaluate the efficacy of individualized therapies. The primary problem with the typical RCT is that is washes out recognition of patient variations that are fundamental to the healthcare philosophy represented by Integrative Medicine. This is very well demonstrated by the inconsistent results of the nutritional and food additive avoidance treatment of conditions ranging from ADHD to autism to migraine headache. When the typical controlled study evaluates, for example, the effects of food additives on children with ADHD, the results do not show statistical significance.¹ However, when the subset of children who appear to react are studied separately in controlled studies, the results are strong and dose dependent.² Unfortunately, an inexplicable bias appears to inhibit this type of research as exemplified by the abstract which starts “Food additives can be regarded as the safest constituents of our daily food.”³ Interestingly, the article goes on to suggest a pyridoxine deficiency may be the culprit in idiosyncratic reactions to food additives!

 

Our society has invested huge resources in researching the disease diagnosis and treatment healthcare paradigm. We've reaped great benefits from this research. None-the-less, we suffer a huge and growing burden of chronic degenerative disease. While some argue this increased incidence is due to the aging population, and this is certainly at least part of the explanation, the increase in chronic degenerative disease has been seen in virtually all age groups. The growing incidence of chronic degenerative disease and progressively more expensive interventions that are bankrupting our healthcare system will continue to worsen until we fundamentally change our healthcare priorities. The time has come to stop investing virtually all our healthcare research dollars in the disease model and invest instead in public health (after all, 75% of the increased longevity of the past century was the result of public health measures) and individualized healthcare.

 

I believe such an investment in healthcare that recognizes the unique needs of each individual will pay off in a dramatic increase in health with attendant reduction in disease and healthcare cost burden.

 

 

1.     Krummel DA, Seligson FH, Guthrie HA. Hyperactivity: is candy causal? Crit Rev Food Sci Nutr. 1996 Jan;36(1-2):31-47.

2.     Rowe KS, Rowe KJ. Synthetic food coloring and behavior: a dose response effect in a double-blind, placebo-controlled, repeated-measures study. J Pediatr. 1994 Nov;125(5 Pt 1):691-8.

3.     Houben GF, Penninks AH. Immunotoxicity of the colour additive caramel colour III; a review on complicated issues in the safety evaluation of a food additive. Toxicology. 1994 Aug 12;91(3):289-302