Understanding Drugs

I recently congratulated a patient on getting off of all drugs after I surgically cured her chronic sinusitis and she was able to stop her asthma inhaler. She remarked that she wasn’t off all drugs — she was still on thyroid hormone. She wasn’t aware that drugs and hormones are two different things.

Hormones are a native part of the human body. Your body manufactures them. If it didn’t, you would die. It is often useful to supplement them when production is suboptimal. This happens commonly as we age.

Drugs are foreign to the body. Antimicrobials target invading bacteria and viruses, but other drugs alter the body’s functioning in some way to achieve a specific result, such as lower cholesterol or blood pressure, a slower heart rate, decreased inflammation, etc. They usually do this by either blocking the action of a specific enzyme or by altering the receptor for a hormone or other cellular messenger, although in many cases we have no idea how a drug works. In order for drugs to produce any benefit, the underlying process that they alter should be defective or maladaptive in some way.

Americans are taking more drugs than ever, and it is important as an educated consumer to understand them. I read in a prominent journal that the average senior citizen is on 7 different drugs. That’s a lot. Aside from each drug taken individually, there are numerous interactions possible, most of which haven’t been tested.

I like to think of the human body as a biologic machine.  Like any other machine, it has discrete components that allow it to work, like gears and springs inside of a watch. Anyone with a mechanical background understands that machines are made up of component parts that have been designed to work together to perform a specific function.

Biologic machines obviously differ from non-living machines in the sense that they are far more complex than anything man-made, and that in being alive, they are self-repairing and also internally create most of the components that are used to make the machine run. These components include the structures that make up the organism, as well as special proteins called enzymes that are required to manufacture other components. There are many other components as well, such as hormones mentioned above, which function as messages from one organ to another – similar to “snail mail” but carried through the bloodstream. If all these components are properly assembled, then they will work well, and generally we ought not to interfere with them for any significant amount of time.

That leads into the question, how well engineered are we? We all are born with slightly different DNA sequences, and we are discovering that each of us has small DNA areas that are suboptimal because of what are called SNPs – single nucleotide polymorphisms. You can find out what SNP DNA defects you might have by getting an inexpensive analysis, which I recommend. These DNA defects affect how a particular component is manufactured, which can increase your risk of certain diseases as you age, and you can take steps to mitigate these risks.

Problematic SNPs notwithstanding, over two million years of evolutionary pressure has slowly resulted in the human physiology that you currently own. That’s a lot of time to correct deficiencies and make adjustments. With so much time, we and other animals should have become very well engineered, to say the least.

Placing any well-designed machine into its optimal environment should result in that machine’s optimal functioning. This is the same as matching a machine to its “design spec.” Just like flying an airplane within its “envelope.”

What is the optimal environment for the functioning of a human being? What is our “spec”?

Most likely, it is what we were exposed to for the majority of the time we evolved. There is a huge debate about what this is precisely, but in my opinion it would include a hunter-gatherer diet with zero processed foods, little artificial light and modern stress, lots of exercise and at least moderate sun exposure. Not coincidentally, this type of lifestyle often results in a dramatic reversal of poor health in many patients who are willing and able to try it — patients who traditionally are given a laundry list of drugs to take with little attention paid to what they eat and how they live.

Unless there is a specific physiologic or genetic defect identified in an individual which a drug can rectify, it is unlikely that drug therapy is the best choice to improve your health. This is the reason that the evidence for the efficacy/utility for the vast majority of drugs that are meant to “extend/improve” our lives is very poor. Not to mention the inevitable “blow-back” side effects all drugs can have that affect your quality of life.

If you are on a long-term drug, look at your lifestyle and diet – and do your best to fix them. Americans are not as chronically ill as we are because we need more and better drugs. We are sick because we live in a toxic environment.

If you are sick or depressed, it’s probably not because you have a Lipitor, Metformin, or Prozac deficiency. Changes you can make to to bring your lifestyle more in line with the environment to which you are genetically adapted is a far better bet to optimize your health than taking a drug, and you should focus on this first.

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