Family & Education

Medicine Needs to Be Personalized, Here’s Why

Medicine needs to be personalized because the same symptoms can arise from many different causes
BY Kathy Koch TIMEApril 5, 2022 PRINT

Each of us has a unique life with different mental, physical, and environmental factors affecting our health. We may get similar sicknesses but for entirely different reasons, and that means the treatments that will help us get better should also be different. This inevitable diversity should be accounted for in our health care, but it rarely is.

When I published my first book, on the autoimmune mechanisms of Hashimoto’s hypothyroidism, thousands of emails began pouring into our office. My book emphasizes that treatment based only on lab values fails to address what is making our readers sick in the first place. Lab values are a necessary part of care, but they’re just indicators. And while medication may normalize lab values, patients continue to suffer symptoms.

Email after email, overwhelmingly from women, described personal tales of lost hope and an inability to do the things they once loved. They also described being belittled or dismissed so routinely by their doctors that they started to believe that maybe they really were making up their symptoms.

Research from the American Autoimmune Related Diseases Association backed up what we saw in these emails: A study showed that 46% of autoimmune patients were told by their doctors that they were complainers and overly obsessed with their health.

They were dismissed because their bodies refused to fall into streamlined diagnostic codes, insurance guidelines, and one-size-fits-all drug treatments. When they read my book, it was the first time that many of my readers felt heard and validated. “Maybe I’m not crazy after all!” was the common refrain.

One Condition, 10 Patients, 10 Different Reasons

In an attempt to make health care more efficient and minimize costs, data-driven algorithms are used in patient diagnosis and treatment. Unfortunately, a patient suffering from an undiagnosed autoimmune or other chronic health disorder rarely falls into these pat flow charts.

In fact, in my practice, I may see 10 patients with the same condition, yet all 10 will have arrived at their disease for different reasons. Often, each will have a different set of symptoms and lab values. As such, effective treatment depends on their individual underlying mechanisms.

Autoimmune conditions can be particularly tricky in this regard. This helps explains why significant numbers of autoimmune patients fall through the cracks; it takes the average autoimmune patient at least five years, visiting five doctors, before they receive an accurate diagnosis and treatment.

I have seen much worse scenarios, with many patients spending thousands of dollars and visiting upwards of 20 doctors over 10 years or longer in their quest to understand why they feel terrible and what to do about it.

This also extends to patients suffering from other conditions that fall outside the walls of the mainstream medical paradigm, such as chronic fatigue, fibromyalgia, Lyme disease, mold toxicity, chronic viral or bacterial infections, intestinal permeability (leaky gut), food sensitivities, neurological issues, and so on.

Personalization Needed for Effective Treatment

Many medical issues, such as a knee injury, pneumonia, or birth difficulty, for example, have straightforward diagnosis and treatment algorithms. We are blessed to live in a time when advanced treatment can keep us alive through conditions that once easily killed people.

However, we also live in a time of unprecedented rates of chronic health conditions. Thousands of studies point to multiple variables such as toxins, processed foods, chronic stress, sleep deprivation, a sedentary lifestyle, pollution, and more that spring from the industrialization of everyday life—the downside to progress.

Diagnoses of autoimmunity now dwarf cancer and heart disease combined and continue to rise at a rate of about 5%–7% a year. More than three-quarters of autoimmune disease patients are women, and this growing epidemic sadly affects their children, as well. Studies increasingly show links between maternal autoimmunity and childhood brain development disorders such as autism, ADHD, and learning disabilities. Autism now affects a staggering one in 44 children and is widely recognized as having autoimmune underpinnings.

Remember, these are rates of diagnosed autoimmunity. Undiagnosed rates are estimated to be as high as 80% for some diseases.

Part of my journey as a clinician, researcher, author, and educator has been to identify these variables in the research so that I can help patients identify their own. Only when you capture the underlying causes of a chronic health condition do you have a shot at lasting, effective management.

Personalized, Functional Medicine Addresses the Whole Patient

You may have noticed that the term “functional medicine” is becoming more popular. I also use the term “personalized medicine,” which refers to looking at a chronic health disorder through the scope of the whole patient and the many variables that comprise their current life, their history, and their health. It also means going beyond a standard blood test in order to measure immune markers, autoimmune antibodies, gut health markers, toxic burden, hormone levels, blood sugar handling, and so on.

We even address factors such as the health of the patient’s relationships, work life, and home environment. Patients struggling through a very stressful home or work environment tend to have poor outcomes because of the inflammatory nature of chronic stress and conflict. Sometimes a patient with an autoimmune or chronic health condition must make big life decisions for the sake of their health.

In functional medicine, we commonly use the “engine light” analogy. If the engine light of your car comes on, do you find a way to turn off the engine light, or do you investigate under the hood?

Functional medicine is not about giving you a drug or supplement for each symptom, but instead investigating why you have those symptoms in the first place, and working on that.

Until you understand why you are suffering from your autoimmune or chronic health condition, chasing after drugs or therapies can keep landing you at dead ends, costing you thousands of dollars in the meantime.

Common Causes for Chronic Conditions

In functional medicine, we look for the underlying mechanism—the “root cause.” Examples include:

  • Food intolerances, especially to gluten and dairy.
  • Chronically high or low blood sugar.
  • Chronic infections.
  • Intestinal permeability, or leaky gut, when an inflamed and damaged intestinal lining allows undigested foods and pathogens into the bloodstream, triggering inflammation.
  • Brain-based mechanisms such as brain inflammation, poor vagus nerve activity, or accelerated degeneration.

Addressing such underlying factors can help you better manage your autoimmune or chronic health condition, improve your lab markers, alleviate multiple symptoms, and restore function and well-being.

There Are No Separations in the Human Body

The body is a highly complex web in which all systems and parts are interconnected.

The body does not have specialties in the way that medicine does. The digestive system—or any other system in the body—does not function independently of the rest of the body.

For instance, if autoimmune disease is destroying the thyroid gland, you must treat the immune system along with the thyroid. If your gallbladder is acting up, going gluten-free to lower inflammation may prevent surgery. If your depression is stubborn, addressing an unhealthy gut microbiome that is inflaming your brain may be the solution.

This is why medical algorithms fail many patients today: Each symptom and disorder does not follow an orderly, linear path. Instead, we must account for multiple facets in the patient’s life and medical history.

Most importantly, we must not denigrate and discard patients if they do not fit into a particular algorithm or flow chart. Instead, we must respect and dig deeper into the never-ending mysteries of the human body and push ourselves to learn more to better serve our patients.

This article was originally published in Radiant Life magazine.

Kathy Koch
Dr. Kathy Koch (“cook”) is the founder of Celebrate Kids and Ignite the Family, a faculty member at Summit Ministries, and the author of five books including “8 Great Smarts” and “Start with the Heart.” Dr. Koch earned a Ph.D. in reading and educational psychology from Purdue University.
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