Your Side Effects Are Real
SNP’s—The Elephant in the Treatment Room.
As physicians, we are taught, first and foremost, not to harm. Primum non nocere. Unfortunately, this divine concept of “do no harm” has been bent and twisted into the concept of risks vs. benefits—where harm is acceptable. This devolution of primum non nocere into more of a treatment craps shoot where with luck, the benefits will outweigh the risks is primarily due to a combination of an ever-increasing pressure to conform to “standard of care” medicine and our toxic medicolegal environment. The elegant art of healing individuals has been reduced to a mechanical trade-like intervention for the masses that anyone or anything (AI) with access to the proper algorithms may practice.
The purpose of this article is to impress upon you, the patient, that you are now responsible for primum non nocere. You are in charge of ensuring no harm is done to you just because our medical system dictates a specific approach. Pay attention and do not deny your observations and opinions about the effects or side effects of treatments you chose to engage in. This applies to the traditional interventions of pharmaceuticals and procedures of allopathic medicine, as well as the myriad of non-traditional healing options. If something doesn’t feel right, PAY attention! Do NOT just accept that how you feel after a particular intervention, medication, or supplement is all in your head or a “healing crisis” or any of the rationals you might be given when a specific treatment has an unexpected or unusual response. This is not to say that these rationales may not be correct. Perhaps you ARE a bit neurotic, and what you are feeling is in your head. Perhaps it IS a healing crisis, and the next deeper level of healing is the new disorder. The point is to pay attention and listen to your own body. If a medication or supplement makes your skin crawl, Geez, just stop it! If your back feels better every time you go to a chiropractor and your neck feels worse, this is not your problem; the chiropractic treatments need to be changed.
In this section, I will demonstrate why you need to pay attention when taking pharmaceuticals and natural supplements. By the end, you will understand that you are unique in the most basic of ways, and subsequently, your response to a particular medication or supplement will be yours and yours alone. If you take a medication or treatment, what you feel in your body and mind is valid. If it is uncomfortable, it needs to be addressed. If you express these concerns and do not feel heard or, even worse, dismissed, move on.
Although the medications provided in the USA are safe and probably the safest in the world, that designation of safety is based upon the FDA’s evaluation of the average response of a small sample of people. The sample numbers can range from perhaps 100 people (in the case of rare diseases) to up to 50,000 for such things as a COVID-19 vaccine. When it approves a medication, the FDA states that, on average, this small number of people who were tested received some benefit from the medication, and the side effects were usually tolerable. The significant concern is that although the medication may have been safe, on average, for this small number of tested individuals, it can, at any moment, be very unsafe for a non-average person. Unfortunately, or fortunately, we are all non-average.
Most of us are not “average” because the DNA of any individual is only 99.6% common to all human beings. This 99.6% provides the essential information to construct the requisite body parts necessary to fit the category of human beings. The remaining 0.4 percent accounts for all the exquisite variations of humanness we find in our world: the good—and the not-so-good.
DNA contains the instructions for making and assembling all the proteins that are the building blocks of our body. Proteins are made up of long chains of molecules called amino acids, and each protein has a unique sequence of amino acids that determines its specific shape and function.
Our DNA is composed of approximately 3.2 billion pairs of molecules called nucleotides. There are only two different pairs of nucleotides in DNA, and they are connected one after the other in a specific order. The order in which they appear defines what and how proteins will be made.
If the order of the nucleotides in a strand of DNA is altered, then the corresponding protein’s shape and function will also be changed. These variations in order are called mutations and are most often a result of the substitution, deletion, or addition of a single pair of nucleotides in a particular section of DNA.
There are many causes for these mutations, and they often happen during the copying of DNA that occurs in reproduction. These errors are inherent to the process and account for the vast differences among humans in many ways. Other causes of mutation can be exposure to nuclear radiation, sunlight, environmental pollution, cosmic radiation, radon from the ground, and even infections by viruses.
These individual base pair mutations are called single nucleotide polymorphism (SNP “snip”) Single ( meaning one pair) Nucleotide (one of the four different molecules that are the alphabet of DNA) Polymorphism (poly = many, morphism = structure).
The importance of these single mutations is significant. A single SNP causes diseases such as Cystic fibrosis, sickle cell disease, and hemochromatosis.
The science of medicine has limited knowledge of these SNPs and how they affect our well-being. As discussed earlier, the DNA defines the shape and function of proteins. If the DNA has mutations, then the proteins produced by that DNA will be distorted (non-average). The shape of the protein is critical to its function. Even one mutation of one single nucleotide can change the shape of a protein to such a point that its function may be diminished, increased, or perhaps not even work at all.
An example of this would be how different people react to narcotics. Many folks can take narcotics for short periods and experience very little or no withdrawal. Others, even after a few doses, will experience symptoms of withdrawal. Some folks have an astounding tolerance to narcotics and receive almost no benefit from large doses; others are hypersensitive to even the smallest amount. These variations in response to medication are a direct result of DNA mutations creating proteins that assimilate and respond to narcotics differently. When an individual becomes addicted to narcotics, it is essential to understand this is a disease caused by a mutation in their DNA, not a weakness of character. On a side note, to deny 85 percent of the population access to opioid pain medication because of the 15 percent that are predisposed to addiction may not be the best approach either.
Because of these significant differences in DNA, I have always been reticent to prescribe medications. As wonderful as medical science is, and with all the information we have accrued over many years, the reality is we don’t know what a particular medication will do in one specific body. The FDA assessment of medication safety for the average person is, at this time, the best we have. However, it is not particularly useful regarding safety for a non-average individual. With each person having millions of DNA mutations compared to the next person, the chances of having a different response to a medication are likely. When you pull out that medication information sheet and read the list of side effects, each one of those adverse events indicates how one or more non-average individuals’ bodies reacted to that medication. And remember, that was only a tiny sampling of humanity. Every time I give a medication, there is a part of me that feels like I am rolling the dice; I cross my fingers and hope for the best. It’s not a great feeling, AND it’s not just about pharmaceuticals.
One of the advantages of taking FDA-approved pharmaceuticals is that you know what you are getting. If you react poorly to a prescribed medication, it is not difficult to assess what the offending drug molecule might be. However, once you navigate beyond the overview of the FDA (not the best, but the best we have), you enter the Wild West of ingestible and injectable healing modalities. And it IS the wild west. Thirty billion dollars per year is spent on unregulated supplements alone!
My concerns are multiple. Often, naturopathic/herbal remedies combine many different components in one dose. Even more complicated is that each of these substances can be actual plant material, which in itself is composed of a vast number of different types of molecules.
When you take a “natural” medicine, you may be exposing your system to a large number of unknown substances, any of which may not be well-tolerated. The risks of negative occurrences increase significantly. And, should you have an adverse reaction to a compound in the supplement, you cannot ascertain which substances caused the reaction and will have to avoid ALL the components of that supplement in the future.
The issues with being exposed to multiple substances at once are not limited to non-allopathic interventions. The last piece of concern regarding taking supplements or pharmaceuticals is the concern for polypharmacy. Polypharmacy is when a patient, due to their multiple conditions, requires taking many different drugs/supplements simultaneously. Medicines and supplements interact with each other as well as with your uniquely DNA-defined chemistry. Every time you add a drug, herb, or supplement to your regimen, there is not only the risk that the new agent will not work well with your particular uniqueness but also that combining it with the rest of what you take may result in adverse drug to drug or drug to supplement /herb interactions.
These interactions can result in a delayed or increased metabolism of the drugs, leading to abnormally high or low concentrations, abnormal efficacy of the medications, working too well, or not at all. Sometimes, these interventions are a result of two different medications combining to form a third, totally different compound in your body with unique adverse effects.
Examples of drug/drug interactions:
Some herbs have a blood thinning effect, and when combined with pharmaceutical blood thinners, may result in severe bleeding events
Blood pressure medications may not be fully metabolized before taking the next dose, resulting in very low blood pressure, falls, and bone fractures.
Combined medications may cause liver or kidney disease and failure.
In conclusion, you are unique, and the practice of medicine is average. Treatments are risks vs benefits, and only you can assess your unique response to that intervention. It is up to you to ensure no harm is done as you travel your healing journey