{"id":576,"date":"2017-05-16T22:08:19","date_gmt":"2017-05-16T22:08:19","guid":{"rendered":"http:\/\/joshmitteldorf.peachpuff-wolverine-566518.hostingersite.com\/?p=576"},"modified":"2017-05-16T22:08:19","modified_gmt":"2017-05-16T22:08:19","slug":"the-only-experimental-subject-who-matters","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/joshmitteldorf\/2017\/05\/16\/the-only-experimental-subject-who-matters\/","title":{"rendered":"The Only Experimental Subject Who Matters"},"content":{"rendered":"

We have come to expect that clinical trials require thousands of participants, tracked over years or decades. \u00a0Even for measures of clear long-term value like exercise and vitamin D, the trends have to be wrenched from the scatter with statistical vicegrips. \u00a0The message in this situation is that individual responses to any intervention vary widely, and the individual variation is far larger than the average effect. \u00a0Does this suggest an individual strategy for your personal health? \u00a0One man\u2019s food is another man\u2019s poison. \u00a0You are not an average. \u00a0There\u2019s enormous potential benefit if you can figure out which side of the curve you fall on. \u00a0Of the many supplements and diets and practices that are beneficial to some people but not others, which is most helpful to you<\/strong>?<\/em><\/p>\n

Headline: Soon, Medication Will be Custom Tailored to Your Specific Genetics<\/strong><\/a><\/p>\n

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Everyone agrees that individualized medicine is the wave of the future. \u00a0You don\u2019t have to wait for a gene map that tells you exactly the right treatment for your personal gene combinations. \u00a0With a little patience and discipline (ok\u2014maybe a lot of discipline), you can find out for yourself. \u00a0What you need is a system for trying many different ideas\u2014the more diverse the better\u2014and a notebook or spreadsheet for recording what you notice.<\/p>\n

There are many conditions at which Western medicine excels. \u00a0Vaccines have wiped out polio, which left my father with a right leg 4 inches shorter than his left. \u00a0If you have appendicitis, don\u2019t hesitate to get an appendectomy, and if you contract malaria, thank science for quinine. \u00a0\u00a0<\/p>\n

But there remain many conditions for which Western medicine has no answer, and standard practice is to mask symptoms with temporary expedients. \u00a0It means only that medical science has not identified a cure that works for everyone<\/em><\/strong>; there may well be something available that can cure you<\/em><\/strong>.<\/p>\n

All of \u201cevidence-based\u201d medicine is derived from studies of many people, usually thousands of people, sometimes millions of people. \u00a0The usual situation is that individual responses vary all over the map, and what is reported is the average. \u00a0<\/p>\n

If there\u2019s an absolute cure, no side-effects, no recurrence, but it only works in 20% of the subjects, you won\u2019t even hear about it. \u00a0If there\u2019s a cure that requires discipline\u2014for example, a rigorous exercise program or a severely restricted diet–you\u2019ll never hear about it even if it works for everyone, because the study will be undermined by \u201ccompliance issues\u201d.<\/p>\n

Of course, let\u2019s learn all we can learn from large-scale studies. \u00a0But don\u2019t let\u2019s stop there. \u00a0The one experimental subject you care about is the one over whom you have the most control. \u00a0You are not an average, but you are knowable\u2014your tolerances and your limits, your preferences, your individual and highly specific response to a medication or a diet or a new rhythm of sleeping and waking, of discipline and free play, of working and working out.<\/p>\n

The procedure is perfectly straightforward and common sensical, though few people are doing it. \u00a0It is the essence of the scientific method:<\/p>\n