n = 1 health care & self-controlled studies.
"Evidence-based" healthcare mushes everyone into one average group who all get the same guidance - that is flawed. It was intended to be general guidance that is individualized further as needed.
A couple quick Substack links and points - “Anything other than N-of-1 medicine is a crime against humanity.” Toby Rogers
Clinical trials use “n=__” as typical jargon to show how big the study was. Larger studies generally are more reliable - bigger group, may more represent “average”. But what is average? No one person is “average”. It is just a math concept. Evidence-based guidance designed to best help the “average” person may not help everyone or anyone. Individual variables may leave some people harmed by the “average” solution.
It is like the Mom-ism - “But mom…… everyone is doing it” - “But child...you are not everyone…if they all are jumping off a cliff are you going to jump off a cliff too?” - “Oh, no I guess not mom, thanks.” The bungee jumping fad proved that many people would jump off a cliff just because everyone else seems to be doing it.
Human instincts are to flock together - to fit in with the group and mimic each other. That doesn’t mean it is always a good idea or even sensible.
Self-controlled studies are less average focused, and more individual focused. Instead of having an experimental group of people and a control group of people which has the difficulty of trying to randomly match both groups for variables like age, gender, socio-economic and health status, a self-controlled study has time periods as the experimental and control phases and all participants are tracked over time. Like a Before and After phase - what were their health parameters before an experimental event and what happened to their health after the experimental event?
Jessica Rose has a SubStack today that describes the self-controlled study concept when used for a vaccine type trial. The experimental time period is considered 28 days after the vaccine in the example she provides. Other experiments might designate a longer window to watch for health changes to check for a temporal association with an experimental procedure. Other studies might look at anything that happens after an experimental procedure as the follow-up phase. The value in the study design is that there isn’t a need to match for variables - each person is their own control, so their individual variables are an exact match for their own individual variables.
My Retinoid Toxicity/Histamine Excess research proposal is a self-controlled study design. With conditions that are characterized by being heterogenous - varied - trying to mash everyone together into one average is not helpful - the condition itself doesn’t have an “average”. Many birth issues, congenital differences, seem to have a cluster of varied gene alleles that may have some similarities across the individuals, but it heterogenous - not consistently the same gene alleles.
In order to both understand the problem better, and to help the individuals, then we need to look at them all as individuals with a varied and unknown group of gene alleles that may be negatively impacting their health by causing metabolic dysfunction or increased inflammation or chronic nutrient deficiencies. Their health may be able to be helped a lot, but not with an “average” treatment. Their condition is not “average” - it is genetically heterogenous.
A crime against humanity and all of nature is taking place with mRNA and CRSPR gene technology. Decoding the human genome was supposed to be a huge breakthrough - leading to wonderful new medications - or something. The tone is big disappointment - the genes had more “nonsense” than expected and more variability - one gene doesn’t do one thing - typically. The tone in my opinion should be joyous - we can easily screen and identify individuals for metabolic gene alleles that could be helped by dietary changes - and yet we are not doing that, or rarely. Methylation gene differences may be screened for but it is not done as a first step usually and not for everyone.
Unfortunately, my research paper topic is too vast for me to finish by the deadline this week. I have made a lot of progress and will post an updated draft soon but currently I have two papers written that are complimentary, rather than collated. The first half is posted and focuses on the histamine excess and Retinoid toxicity and the second half is in the works. I posted some of the Tables, but the “That is not a Table!” Table is still an enormous run-on Not-A-Table still.
Tables of data help us see patterns - that is what I do - see patterns in data trends. Organizing it into a neat Table or graph makes it easier for other people to see the patterns too. Mathing it all up in neat statistical graphs, though, is not what I do. Figuring out what is for dinner and how to prepare it, out of all that data, for an individual’s needs, is my focus. And the question is more difficult than picking a favorite restaurant - in our modern times, and for individual people with varied health conditions, what we choose to eat may be very harmful to our health. Processed foods are frequently designed to be somewhat addictive or very addictive and often are seriously depleted in nutrients beyond carbohydrate and fat calories.
Pain means you are doing something wrong - it might have been okay when you were younger, but now it is no longer working for you. Change is needed. Pain means change is needed and the individual needs to figure out what changes are needed in order to restore normal function - which is not supposed to hurt. If something hurts, then you are over-exerting or your body has changed and can no longer keep up with your previous pace - something is wrong, whether it is age, or infection, or stress load - something needs to be changed. And that change is probably not going to be as simple as “Take this pill once a day.” However, the medical model is based on the concept that health can be restored if you just “Take this pill once a day.”
The myth of a single medication “cure” was based on the early success of antibiotics, but also the resounding success of discovering “nutrients”. Early food processing changes left entire populations with nutrient deficiencies. Once the nutrient was discovered and the food processing methods were modified to reduce the lost nutrients, or foods were fortified with the removed nutrient, then the entire population suddenly was “cured” of the deadly or disabling “condition”.
The medical industry has come so far that they have lost their roots - scurvy - vitamin C deficiency - is missed in modern health care - left untreated as a mystery condition until someone hopefully recognizes the old sailor disease - scurvy. We all need vitamin C every day. That is a biological fact. Medical doctors need to take their blinders off - the body is not made out of medicine. Not a single medicine is a “nutrient need”. We have no deficit of aspirin in biology, but we might have a lack in our diet. We can get plenty of salicylates in our herbs and spices - nature provides us aspirin in our foods.
Oldie, but a goldie: Carrots, spices and baby aspirin help prevent cancer and inflammation, Oct. 21, 2011, (transcendingsquare.com).
Newer: Being grateful for our bitter sensing tastebuds, Jan. 3, 2018, (transcendingsquare.com).
My Problem Solving episodes in my How Are You Feeling? podcast series gets into more detail about the genetics of bitter taste perception and how it may conveniently be more sensitive in people like me who need an external source of bitter tasting cannabinoids and phospholipids. The transcripts and audio links to the series are on this webpage: Peace-is-happy.org/How are you feeling?.
Bitter taste receptors turned out to be critically important for COVID19 treatments. Bitter phytonutrients or medications can get mucus thinned and flowing during congestion - but adequate zinc is needed first. In order to make the bitter or other types of taste and odor receptors.
Covid era: Bitter taste receptors in the lungs & Hesperidin’s decongestant properties. April 7, 2020.
Zinc, cancer, and bitter taste receptors, Oct 18, 2020.
Mother Nature gave us a medicine cabinet and an ability to taste the dose that will be most effective without being excessive (starts to taste bad instead of good) - and “medical doctors” need to get out of the way.
Be an n=1 self care provider and pay attention to your own body and it may help guide you towards less pain and better quality of life. The negative symptoms tend to be later that night or next day after eating inflammatory foods or doing inflammatory activities so the patterns can be easy to miss if there is a lot of variability in a person’s routine habits and diet choices.
The paper and Tables that I have been working on will hopefully make it easier to see what individually is helping or hurting. I will post another update this week but it isn’t quite blog ready, let alone journal submission ready.
Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.
Yes, I could not agree more. Thank you for making this case.