Tuesday, April 21, 2015

n=1 trumps RCTs

Although everyone's default mental image of the bird called a swan is white, there are black ones out there.  In the world of medical research, the typical test subject is a Taleb-ian white swan -- a young healthy male human, ... or maybe a mouse or rat.

In the real world, most people who NEED the information theoretically provided by research are black swans -- "damaged" children and young women, and older people of both sexes with innate or acquired health issues.

When in the course of human events, it becomes necessary for us to dissolve our reliance on Official Medical Dicta ... i mean, uh, we get totally fed-up with Conventional Wisdom and say "screw what doesn't work -- i need something that DOES" it's rare that RCTs give us the answers we need.  We spend long hours searching the 'net till we find a cluster of people who share our problems and have found some degree of relief.  VOILA:  it's anecdotal evidence which actually helps.  Black swans to the rescue.

Because official research is often designed to confirm what is already believed, as opposed to GOOD SCIENCE which should be designed to try to find cracks in one's hypothesis.  Even if the typical study shows something different from what is expected, the authors rarely reveal their surprise -- they double-talk, torture data, and sometimes even unashamedly lie about what they found.  Is it any wonder that with the billions spent on research, so little of it has improved human well-being?  Sold a lot of drugs, definitely, but IMPROVED WELL-BEING...?

When i determined that those white-coat people were doing little but running me around in circles, and i decided that i couldn't do MUCH worse for my health than they were doing, i started looking things up for myself.  All THEY wanted to do was boss me around, make money off me, and shoo me out of the office;  all I wanted was improved quality of life.  My goals were much more logical, and my approach more to the point.  Instead of dozens of blood tests which would tell me nothing new, i spent my money on supplements which others (some of THEM in the medical industry) had found to actually make people function better.  My early success emboldened me.

I read more and more, trying new foods and supplements one at a time to see what impact they actually made.  I stopped taking some for awhile then restarted, in order to confirm my original impressions.  I used the observations of others to help determine which forms and brands were better or worse.  I closely observed how i felt, eating and drinking and supplementing, as well as how sleep and light and weather influenced my sense of wellbeing.

...And ya know what -- my approach works for me.  Over and over again, i've confirmed that conventional wisdom is completely wrong for this body.  Every time i eat "what everybody knows is healthy" i feel worse:  vegetables make me feel worse; exercise makes me feel worse; low fat intake makes me feel worse; dairy makes me feel worse; healthywholegrains (especially wheat) make me feel worse.  What works for the white swans doesn't do me a damned bit of good.

Supplementing the right vitamins/minerals makes me feel better, despite the disparagement of those who claim they only make for expensive urine.  Anecdotal evidence [gasp] of long-dead clinicians provides the clues to how the right super-foods improve health, and the n=1 reports of individuals reveal the wonders of what happens when B12 is supplied to the deficient, or preformed vitamin A to a poor converter of beta-carotene.  Supplementing vitamins to white swans (who aren't deficiient at baseline) doesn't result in improvements in health, therefore "vitamins don't work" is the default medical opinion.  But ONLY eating whole foods isn't enough for a black swan like me, because i neither absorb nor convert like a white swan.

SO MUCH can be done to improve health and resistance to disease, through diet and supplementation!  For several years I've been so immersed in the writings of a coterie of brilliant minds in the nutrition world, i often get a shock when i'm reminded of what most people believe to be a healthful lifestyle.  I see how their illnesses and chronic conditions are obviously related to their diets and activities, and i'm astonished that they don't observe it in themselves, and resolve to discontinue what so patently DOES NOT WORK.

But they listen to advertising shills, and make the mistake of believing what they're told by people who merely want to sell something.  They believe that MDs and RDs know enough to give them good advice, and don't seem to realize that these people, TOO, have been sold a bill of goods by Big Pharma as well as Big Ag/Food.  They believe that the USDA and FDA are there merely to protect them from the unhygeinic, quacks, and snake-oil salesmen.

Alas, some people are probably not wise to take their health into their own hands.  They NEED reliable medical advice ... but where are they going to get it?  Perhaps in the next generation of clinicians who are being trained by the likes of Dr. Feinman?  Call ME over-optimistic for thinking this might be possible....


  1. You'd think that the fact that almost everyone in the medical profession (except dentists) is 50 pounds or more overweight would tell people they don't know anything about good diet.

    1. :-) yeah, i've noticed that too.... of course, then there's Mike Eades and Wm Davis and Andreas Eenfelt and ....

  2. Many doctors suffer themselves from the imperfect standard health advise. My GP's weight fluctuates a lot, as I can see. When my health were heading south, he sincerely told me it was just the part of getting older, and tried to deal with my symptoms. He told me that, according to medical literature, diets didn't work long term. I guess, it is easy to grow pessimistic for the people in a such profession.

    There is definitely a metabolic diversity in a population. For example,I met several adult people who reacted on consumed sugar bombs as stimulants. Still, that sugar didn't do their health anything good, and the stimulant-quality made sugar-limiting more difficult. For the people like us ,who feel worse almost immediately after eating foods with a high carbohydrates content, it is easier to eat healthier.

    1. definitely -- when we know we're going to suffer when we eat the wrong thing, it sure reinforces our desire to eat RIGHT!