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A New Era of Medicine Has Finally Arrived

August 26, 2010

JUST BECAUSE YOU HAVE a diagnosis doesn’t mean you know what’s really wrong with you! Don’t believe that? I didn’t used to, either! As a doctor, I was trained to believe that all people with the same diagnosis were the same.

That means, I thought that one person’s asthma was the same as someone else’s asthma and that depression was the same in everyone. That made my job pretty easy — once I made the diagnosis, all I had to do was match the pill to the ill, the drug to the disease.

What’s wrong with this approach? When doctors practice medicine this way, we end up treating the NAME of a disease — not the CAUSE. The truth is, everyone is different, even people with the same diagnosis.

I have no doubt that this treatment changed my patient’s life — and that this way of viewing disease is the new way of practicing medicine.

Take a group of people with the same condition — let’s say depression. That group might be depressed, but they may have 10 different causes for it. How does conventional medicine treat this group? Everybody gets an antidepressant — and that’s that. But that’s not how I practice medicine. The way I see it, if there are ten different causes for depression in that group, we need ten different treatments.

So one person might need fish oil to help his brain work better, while another might have a vitamin B12, folate or vitamin D deficiency, another might have a poorly functioning thyroid gland, another might have mercury toxicity — and so on and so on.

Here’s another way to think about it:

Imagine that you’re standing on a tack. How would you treat the pain? The obvious answer is that you’d take the tack out of your foot. You wouldn’t just keep taking aspirin until it felt better. But that’s exactly how most doctors treat illness!

If you have depression, you can take all the antidepressants you want, but if your sluggish thyroid isn’t treated or your vitamin B12 level isn’t restored to optimal, you won’t get FULLY healthy. Now imagine that you’re standing on two tacks. Removing one of them doesn’t make you 50 percent better.

You have to find and remove ALL of the tacks if you want to feel better. So that means that if you’re depressed, you could have low thyroid, a B12 deficiency, and three other reasons for depression — and they all need to be addressed. Plus, just one CAUSE can create 10 or more different diseases.

For example, if you have the gene that causes celiac disease (an intolerance to gluten), it can show up as nearly 100 different diseases — from kidney failure to osteoporosis to iron deficiency to hypothyroidism to rheumatoid arthritis to psoriasis to chronic fatigue and so on.

Most doctors will prescribe the right drug for the kidney disease, osteoporosis, iron deficiency, or hypothyroidism. But treating all those conditions individually doesn’t take the “tack” out of your foot — and the cause of your problems won’t be solved.

So if you’re taking a drug that just masks your symptoms but doesn’t treat the underlying problems, you may feel better for awhile — but the disease keeps progressing. It’s like having a broken ankle. If you take enough pain medication and produce enough adrenalin, you could run on that ankle — but the ankle won’t heal. That’s how modern medicine treats disease!

It’s been said that, “The greatest obstacle to discovering the shape of the earth, the continents, and the oceans was not ignorance but the illusion of knowledge.” The same can be said for medicine. What we think we know about disease just isn’t working.

That’s why we are at a crossroads, where the old ideas we have about disease and diagnosis become less meaningful as we understand more and more about the importance of individual differences in determining illness.

In fact, we are at a time in medicine where the old ideas are rapidly becoming obsolete. The new medicine says the world is round, while the old medicine says the world is flat. It’s clear where we’re headed. This a time when personalized medicine will replace medicine based on diagnosis and disease.

In fact, disease and diagnosis as we know it will soon be an obsolete concept — just like blood-letting or phrenology (the art of diagnosis based on the shape of your skull). Doctors treat obesity now just like they treat disease – a simple knee-jerk reaction that says, “Well, just eat less and exercise more”.

In fact, it’s much more complicated than that as many of you reading this probably already know, which is precisely why I wrote UltraMetabolism — to address ALL 7 of the major underlying causes of obesity so you can address them. Treating patients this way is the basis of all of my work.

Take, for example, the story of a patient who had a diagnosis of dementia and came with his wife to see me because he could no longer manage his business affairs, had become increasingly unable to function at home, and had to withdraw from family and social relationships.

He was desperate as he felt himself slipping away. Let me give you a little background. There is no effective known treatment for dementia. But we do know a lot about what affects brain function and brain aging: our nutrition, vitamins, omega-3 fats, hormonal deficiencies, inflammation, environmental toxins, stress, and exercise.

Our genes have also been found to contribute to dementia. It is not one gene, but the interaction between many genes and the environment that puts someone at risk for a chronic disease such as dementia. We also know that many things affect how our genes function — our diet, vitamins and minerals, toxins, allergens, stress, lack of sleep, exercise, and more.

Even though no long-term studies have yet been done looking at treating dementia based on genes, there are so many scientific threads that weave together a picture of how and why our brains age and what genes are involved. That’s why I felt confident treating this man — whose mind and life were evaporating — by addressing his genes.

To do so, I looked deeply into his genes and the biochemistry they controlled and found places we could improve things. For starters, he had a gene called Apo E4 that is a high-risk gene for Alzheimer’s disease and also made it hard for him to lower his cholesterol and detoxify mercury from his brain.

He also had a version of a gene for detoxification of metals and other toxins (glutathione-S-transferase) that was very inefficient, making him accumulate more toxins over his lifetime. He had another gene called MTHFR that made him require very high doses of folate to lower his blood levels of homocysteine, a substance that’s very toxic to the brain.

Lastly, he had a gene called CETP that caused his cholesterol to be high, which also contributes to dementia. But that wasn’t all. I also found that he had high levels of mercury, a toxic metal that affects brain health. So how did I treat this patient?

First, I helped him detoxify by asking him to eat foods such as kale, watercress, cilantro and take herbs such as milk thistle, nutrients such as selenium and zinc, and medications that helped him overcome his genetic difficulties getting rid of toxins.

I helped him lower his cholesterol with diet and herbs. And he lowered his homocysteine with high doses of folate. What happened? Well, after a year of aggressive therapy that was matched to his particular imbalances, genes, and causes of his symptoms — NOT his diagnosis — he had a remarkable and dramatic recovery.

Let me remind you of what this patient had been like before. Before I saw him, he could not manage his business. His grandchildren didn’t even want to be around him. But after we matched his treatment to his genes, he was again able to function — and his grandchildren again loved being with him.

I have no doubt that this treatment changed my patient’s life — and that this way of viewing disease is the new way of practicing medicine. This area of personalized medicine, genetic testing, and nutrigenomics is new, and more research is needed. But it’s clear that it’s also an exciting way of looking at disease that’s worth exploring.

Here’s how:

1. Do your homework. You may need to do some research into your disease yourself. Good resources include government and organization websites that end in “.gov” or “.org.”

2. Enlist your doctor. Ask him or her to help you go beyond your symptoms by ordering tests that can help identify root problems. Remember there are ways to find the cause – almost all diseases have a few fundamental causes, namely toxins, infections, allergens, diet, lifestyle, and stress. Be a detective.

3. Consider finding an expert. You may have to search for a doctor who can think differently and address the causes of disease. Many doctors have now been trained in functional medicine — not a new specialty, but a new way of thinking about health that addresses the individual genetic, environmental, and lifestyle causes of disease.

4. Read up. I recommend The Textbook of Functional Medicine, which lays down these principles for practitioners.

Remember, if you have a diagnosis, you don’t necessarily know what’s wrong with you. But there are ways to look through new doors into an entirely new era of medicine that no longer focuses on the disease, but on the person and their uniqueness.

As William Osler, the father of 20th century medicine, said, “It is more important to treat the person who has the disease, than the disease that the person has.”

Now I’d like to hear from you:

Do you have any experiences working with doctors who were able to dig deep and find the root causes of your problem?

Have you been frustrated working with doctors who only treated the symptoms of your “disease” rather than giving you a treatment customized to your own body’s needs?

Do you have any other suggestions for how to get to the root causes of medical issues that you’ve found worked for yourself?

How else can we help to change the current medical paradigm so doctors can be trained in this new type of personalized medicine rather than conventional medicine (which, although very effective at treating acute conditions, has proven to be ineffective at treating chronic problems)?

Please share your thoughts by adding a comment below.

To your good health,

Mark Hyman, MD