No More Guessing

Unlike anything ever seen in the history of mankind, we now have an abundance of technology at our disposal to properly diagnose diseases. In the past, due to a lack of knowledge, the etiology (aka: origin) of some diseases were unknown to doctors. Even today, we still have the term “Idiopathic” to describe ailments of unknown cause. However, the problems being added to the “idiopathic box” are becoming more and more scarce.

Nowadays we have much better knowledge about diseases^[1]. And we can act not only to diagnose them with better accuracy, but also to act in their prevention and cure^[2].

If you are here reading this article, it’s fair to assume that you also agree that doing medical exams is vital for maintaining good health. After all, it is by gaining information about our current state that we can make an educated decision about actions we are taking; or need to introduce. In other words, if we feel good and the results from the exams look good, we are encouraged to maintain our healthy habits^[3]. But, if the results are suspicious, we need to further investigate what’s going on. And review our current lifestyle to target what we are doing wrong or missing.

Unfortunately, the traditional diagnostic approach has several blind spots.

Diagnostic Limitations

What are these blind spots?

The limitations that we face arise from two factors. The first is the lack of knowledge about what we are trying to diagnose. And the second is the technical limitation of the equipment or procedure. A good example of such a situation was the recent COVID-19 pandemic. For a short while, neither doctors nor scientists fully understood the disease. To be honest, many may still not fully understand it today (but that is a conversation for another article). However, with the use of high-end molecular technologies, eventually, the virus was identified^[1]. From that point forward, scientists were then able to create tests to diagnose the virus. Who doesn’t remember those “lovely” nasal swabs tests?

But then we have the second limitation – accuracy. I’m sure you can recall the massive quantity of false positives and false negatives we had during the pandemic. In other words, just because a test exists, it doesn’t mean that it is accurate. Thus, many issues can go unnoticed for so long.

Is this why every year we hear about cases of people that even with their annual checkups, still get surprised by heart attacks, strokes, or cancer? Was this the fault of inaccurate testing? Or, are these fast-evolving diseases that can develop in between checkups?

In reality, we can say that none of the above theories are the main problem.
These diseases develop over time and give us plenty of signs. We just have to know the right data to look for. Ultimately, the issue with our traditional medical approach is that doctors are not asking for the right diagnostic tests. Either because they don’t search for more accurate biomarkers, or because they are limited by what insurance will pay.

Some say that with the introduction of artificial intelligence, we are increasing our accuracy in predicting these and other conditions , , , . However, even AI needs the right biomarkers to be accurate.

Traditional Diagnostics

When we perform an annual checkup, the number of tests that are prescribed is limited. Doctors are choosing to test specific biomarkers that can give us general information about our health. In other words, since we are not testing for everything, many diseases can go unnoticed.

Can we perform a more comprehensive checkup? Certainly! But, that is not insurance–friendly. As you can imagine, insurance companies and the healthcare systems provide doctors with strict guidelines^[1]. Physicians are told to go for the bare minimum; and in some schools, they are even trained to believe they are bad professionals if they need more diagnostic exams. They are brainwashed to think that they will only become great doctors if they can “guess” without using all the data they have at their disposal.

This is a sad reality, but it is the one we are living in. That is why, we as health-conscious individuals, have to take control and responsibility for our health.

Taking Ownership Of Our Checkups

What should we be focusing on every year? What exams should we do?
As with most things in life, there is no one-size-fits-all approach to diagnostics. What is right for you will depend on multiple factors. However, there are three essential categories we have to consider: genetics, epigenetics, and system-specific testing.

Genetic testing can be considered a static test. What this means is that these results will not change over time. Thus, one test is enough in your lifetime. Assessing our genetic makeup will allow us to identify diseases caused by mutations in specific genes . Additionally, as we have talked about in previous articles, our genetics play an important role in determining our natural tendencies to develop certain issues. It’s essential we understand what are our weaknesses so we can create the correct lifestyle responses to mitigate those risks.

On top of this one static test, it’s then essential to combine frequent dynamic tests within the epigenetic category. In other words, evaluate the impact our lifestyle choices are having on our health at that moment in time.

Here are some of the examples of “lifestyle” tests that we can perform throughout our lives:

• Comprehensive “Traditional” Blood Test:
  This common test allows the overall assessment of health^[1]. However, most of us may benefit from adding more biomarkers. For example, instead of just looking at glucose to assess type 2 diabetes, why not assess insulin levels since they represent a more accurate marker?^[2] Or, instead of just looking at LDL for heart disease risk, why not look at a more comprehensive Lipoprotein Fractionation NMR test?The key here is to look at better markers. And, depending on what red flags come from these primary results, then we can perform system-specific testing to further study what’s going on.
• Micronutrient Test:
  Micronutrient tests assess the quantities of several of our much-needed vitamins, minerals, antioxidants, fatty acids, amino acids, and trace elements. This type of test is essential since micronutrients play an important role in our health^[3]. Understanding if we have them in the appropriate quantities will guide help us diagnose certain health concerns (e.g. iron deficiency causing anemia^[4], or low vitamin D as a potential risk factor for dental cavities, diabetes, and cancer^[5] ) and also guide us on the therapeutic approach.
• Chemical Toxicity Test:
  As discussed in our lectures and articles, we live in a toxic world. From exposure to the pesticides used in agriculture^[6], to the particles emitted by burning fossil fuels.^[7] We are surrounded by toxins. And, these toxins can accumulate inside us and act as a poison.^[8] Without realizing it, we may be experiencing symptoms that are being caused by our environmental contaminants. It is then essential for us to assess how contaminated we are and what are the specific toxins causing us harm.
• Food Sensitivity Test:
  Understanding our current food sensitivities not only can help us guide our nutrition but also serve as an indicator for our overall gastrointestinal (GI) health. The more sensitivities we present, the more attention we need to pay to our gut. This can also indicate that further specific GI tests should be done.
• Pathogen Test:
  Finally, another incredibly important test to be done is pathogen testing. This allows us to identify and detect harmful microorganisms such as bacteria, viruses, and fungi that can cause infectious diseases. By identifying these pathogens early, we can take measures to prevent the spread of the disease and reduce the risk of infection. While pathogen testing is important for preventing the spread of infectious diseases, it can also have a broader impact on our health and performance, by helping us identify and address health issues that can hold us back.

Overall, all these different tests allow us to look at our bodies in detail gaining information on our health. Yet, they may still not provide enough information (depending on our predispositions, lifestyle, and symptoms).

So what can we do when all these tests miss something?

In that case, when the nature of the problem calls for it, imaging tests are next in line. Some are more invasive than others, yet they allow us to explore what is going on in the organs or systems. For example, in the case of gastrointestinal disease, we can begin by doing more superficial tests such as intestinal hyperpermeability tests, before going into an MRI or a Colonoscopy.

As you can see, modern technology allowed us to make huge leaps in diagnostic testing. However, the traditional medical approach is not taking full advantage of all the technology that we have at our disposal. That is why we should all take responsibility for our health and look for physicians that understand the importance of comprehensive data.

With proper and frequent diagnostic testing, you will never be caught off guard.
If you want to learn more about this topic and learn about other diagnostic tests we could not mention here, click the button below to check this week’s video lecture.

https://pmj.bmj.com/content/80/946/463
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0265-4

Teaching Patients About Healthy Lifestyle Behaviors: Communication is the First Step

https://pubmed.ncbi.nlm.nih.gov/33199023/
https://www.hindawi.com/journals/complexity/2021/6663455/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8686476/
https://www.theguardian.com/technology/2018/jun/10/artificial-intelligence-cancer-detectors-the-five
https://www.mdpi.com/1424-8220/22/19/7227
https://medlineplus.gov/healthcheckup.html
https://www.ncbi.nlm.nih.gov/books/NBK132154/
https://www.nhlbi.nih.gov/health/blood-tests
https://openheart.bmj.com/content/4/2/e000656
https://pubmed.ncbi.nlm.nih.gov/35365361/
https://www.who.int/health-topics/micronutrients
https://pubmed.ncbi.nlm.nih.gov/28516265/
https://www.who.int/news-room/questions-and-answers/item/chemical-safety-pesticides
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239621/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712864/

Dr.De

Marcos de Andrade MD, MBA
Chief Executive Officer