by Dr. Rangan Chatterjee
Despite the title, there is no trickery or magic involved with this. Getting to the root cause of disease is what I’m passionate about. My TedX talk from earlier this year in Liverpool talks about my journey and why I practice the way I do.
Here’s a transcript of the talk:
“I can make diseases disappear. To be more precise, I can make chronic diseases disappear. Chronic diseases are the long-term conditions like type-2 diabetes, high blood pressure, depression or even dementia. And there’s 15 million people in England that have already been diagnosed with a chronic conditions. That means that looking out amongst you now, there is probably 250 people in here who have one of these long term conditions. Just one of these alone, type-2 diabetes, is costing the UK £20 billion every single year. And I’m standing here before you, saying I can make diseases disappear. I’m not a magician, I’m what the Americans call an MD – that’s not a magical doctor, that’s a Medical Doctor, or what I call a ‘mere’ doctor. The reason I can make diseases disappear is that diseases are an illusion, diseases are not real, diseases don’t really exist, at least not in the way that we think they do.
15 years ago I qualified from medical school and I was ready, full of enthusiasm, full of passion, ready to go out and help people. But I always felt there was something missing, I started off as a specialist. I moved from being a specialist to becoming a generalist (or a GP) but I always had this nagging sense that I was just managing disease or simply supressing people’s symptoms. And then, just 5 and a half years ago came the turning point for me. 5 and a half years ago my son nearly died. My wife and I were on holiday in France with our little baby boy and she called out to me, she said he’s not moving. So I rushed there and he was lifeless, I thought he was choking. So I picked him up, I tried to clear his airway, nothing happened and I froze. She called out to me, my wife said, “Come on, we’ve got to get to hospital.” So we rushed there and we were worried because when we got there he still wasn’t moving. The doctors were worried because they didn’t know what was happening. That night he had 2 lumbar punctures because they thought he might have meningitis – he stayed in a foreign hospital for 3 days. What actually transpired was, my son had a low level of calcium in his blood that was caused by a low level of vitamin D. My son nearly died from a preventable vitamin deficiency and his father, a doctor, knew nothing about it. You see, as a parent that is a harrowing experience, that never leaves you. But I was a doctor, I was his dad and the guilt that stayed with me and is still here today – that changes you.
So I started reading about this vitamin deficiency, and as I started reading, I started to learn a lot of science, a lot of science that I did not learn in medical school… a lot of science that made a lot of sense to me. So I started applying the science, first of all with my son and I saw the amazing benefits. So I started applying it with my patients and do you know what happened? People started getting better, really better – you see I learnt how to resolve the root cause of their problems, rather than simply suppressing their symptoms.
Just over a year ago I got the opportunity to make a series of documentaries for BBC1, where I got to showcase this style of medicine. Let me tell you about one of the patients. A 35-year-old, Dotti, a lovely lady but she was struggling with her health – weight problems, joint problems, sleep problems. Despite Dotti’s best efforts, she was unable to make sustainable changes. So I went into Dotti’s house and on the first week I did some blood tests and I diagnosed her with type-2 diabetes. 6 weeks later when I left Dotti’s house, she no longer had type-2 diabetes – you see her disease had disappeared.
So health exists on a continuum, ok. At the top right we’ve got disease and at the bottom left we’ve got optimum health and we are always moving up and down that continuum. Take Christmas & New Year for example – we drink too much, we eat too much, we stay up late and we probably start to move up that curve. But if we re-calibrate in January and February we start to move back down it again. We get involved in medicine and give you a diagnosis of the chronic disease, here, but things have been starting to go wrong back here. When I met Dotti – she was up here, she had a disease. You can think about it a little bit like a fire that has been burning in Dotty’s body for years, it’s getting bigger, it’s getting bigger until its finally raging out of control and at that point I can say to Dotti, hey you have a disease. And I told her that “You do have a disease.” But what caused it in the first place?
The thing we have to understand is that acute disease and chronic disease are two different things. Acute disease is something we’re pretty good at as doctors, it’s quite simple – you have something like a pneumonia, that’s a severe lung infection, so in your lung you have the over-growth of some bugs, typically a type of bacteria. We identify the bacteria, we give you a treatment, typically an anti-biotic and it kills the bacteria. The bacteria die and ‘hey presto’ you no longer have your pneumonia. The problem is we apply that same thinking to chronic disease and it simply doesn’t work because chronic disease doesn’t just happen. You don’t just wake up with chronic disease one day. And there’s many different causes of chronic disease. By the time we give you that diagnosis things have been going wrong for a long, long time.
So when I met Dotti and she had her diagnosis – her blood sugar level was out of control. Because that’s what people say, many people say that type-2 diabetes is a blood-sugar problem but they’re missing the point. There’s a problem with blood-sugar in type-2 diabetes, but type-2 diabetes is not a blood-sugar problem. The blood-sugar is the symptom, it’s not the cause. If we only treat symptoms, we’ll never get rid of the disease. So when I met Dotti, I said “Dotti, you’ve got a problem with your blood-sugar, Dotti for the last few years your body has become more and more intolerant to certain foods. At the moment Dotty your body does not tolerate refined or processed carbs or sugar at all. So you’ve got to cut them out.” So what does that do? It stops you putting fuel on Dotty’s raging fire but then we’ve got to work out what started the fire in the first place and what was the fuel that caused it to burn for so long.
In most cases of type-2 diabetes this is something called insulin-resistance. Now insulin is a very important hormone and one of its key functions is to keep your blood-sugar tightly controlled in your body. So let’s say you’re at the bottom left in optimal health, like all of us in here, and you have a breakfast of say a sugary bowl of cereal and what happens is your blood sugar goes up but your body releases a little bit of insulin and it comes back down to normal. As you move up that curve you are becoming more and more insulin-resistant, that means you need more and more insulin to do the same job. And for all those years, before you get anywhere near a diagnosis, that raised level of insulin is causing you a lot of problems. You can think of it a little bit like alcohol – the very first time you have a drink, what happens? Let’s say a glass of wine, one or two sips maybe half a glass, you feel tipsy, you feel a little bit drunk. And as you become a more seasoned and accustomed drinker you need more and more alcohol to have the same affect, that’s what’s going on with insulin. You need more and more insulin to have the same affect but that insulin itself is problematic. And when the insulin can no longer keep your sugar under control, at that point, we say you’ve got a disease, at that point you have type-2 diabetes. So what causes this insulin resistance, that then causes type-2 diabetes? Well there’s many different things – it could be your diet, it could be your diet for the past 10 years has been full of processed junk food, that could be a cause. What if it’s something else? What if it’s the fact that you are chronically stressed? Work stress, emotional stress, perceived stress? For me just seeing my email inbox sometimes, that’s a stress. You see that raises levels of cortisol in your body and cortisol when it’s up raises your sugar which causes insulin-resistance. What if it’s something else? What if it’s the fact that you have been sleep-deprived because you are a shift-worker? In some people, one night’s sleep deprivation can give you as much insulin-resistance as 6 months on a junk food diet. What if it’s the fact that as you’re getting older you’re losing muscle mass? That causes insulin-resistance. Or what if it’s something to do with something we call your micro-biome – inside our body we have trillions of bugs living there and the balance of those bugs is critical for our overall health. If you have a disruption to that balance you can get the overgrowth of certain bacteria and on their jacket these bacteria have something called lipopolysaccharide or LPS and what that does is that when it gets in your blood it causes insulin-resistance. You see the problem is there are many difference causes of insulin-resistance and if we don’t address the causes for that particular patient we will never get rid of the disease. That’s what I did with Dotti and that’s why, 6-weeks after I met her she no longer had a disease.
What about something else, completely unrelated. What about depression? One in five people are going to get depression at some point in their lives. So what is depression? There’s no blood test for depression, there no scan for depression – depression is simply the name that we give to a collection of symptoms. What causes the depression, well we know that many cases of depression are associated with something called inflammation. Now this isn’t the same inflammation as if you trip up, you sprain your ankle, it gets red, it gets swollen, it gets hot for a few days. This is entirely different; this is chronic inflammation. This happens when your body thinks it is under constant attack. Kings College London, 3 weeks ago, published a study on this – this is current up-to-date stuff. Patients with depression, if they had high levels of inflammation in their body they did not respond to anti-depressants. Take a step back, it sort of makes sense, doesn’t it? Because an anti-depressant is designed to raise the level of a chemical in your brain but what if the cause of your depression is actually coming from your body and the inflammation that’s in your body, surely it makes more sense to address that? What causes this inflammation? Well, your diet plays a part in that, your stress levels play a part in that, chronic sleep deprivation, physical inactivity, a lack of exposure to the sun which gives you vitamin D, disruptions in the gut microbiome – you see there are many different things – if we do not address the cause we will never get rid of diseases. Diseases are the symptom.
What about something else? What about Alzheimer’s disease? We’re all living longer aren’t we? But we’re scared, we’re scared that as we live longer and as we live older we may have to live with the devastating consequences of things like Alzheimer’s. I’m sure many of us in here have experienced that ourselves or our family. It’s a heart-wrenching condition and we the doctors, we’re scrambling around aren’t we, trying to find the cure. Well there’s a professor, near San Francisco, Professor Bredesen who’s actually demonstrating that you can cure dementia. He’s showing that you can reverse cognitive decline in his patients with dementia and how is he doing that? Well one thing he’s not doing, he’s not saying – well all these patients in my office have got dementia, Alzheimer’s disease – what is the cure? No he’s going the other way, he’s saying with all these patients, let’s say 10 patients in my office, he’s trying to work out what have been the triggers for the last 20 years that have ended up with this patient expressing themselves as dementia? And he identifies them and he corrects every single one of them. And when he does that, guess what’s happening – they are reversing their symptoms, they are no longer being classified as having dementia. It’s a brand new way of looking at disease. Its looking at what is causing this disease in this individual patient, it’s totally different. So what factors is he looking at? Well he’s looking at their diet, he’s looking at their stress levels, their sleep quality, their physical activity levels, their exposure to environmental toxins, etc., etc.
Is this all starting to sound a little bit familiar? What if all these seemingly separate diseases actually at their core share common root causes? We need to update our thinking, our genetics are not our destiny, our genes load the gun but it’s our environment that pulls the trigger, all these factors here – these are the factors that interact with your genes and determine how your genes are expressed; whether you are in optimal health, whether you have a disease or whether you are somewhere in between. Collectively as a society I genuinely believe we can do better and we have to do better. Type-2 diabetes alone is costing us £20 billion a year. Just a 1% saving there would be £200 million and I think we can do way better than 1%. In the United States today, the new generation of kids that are born have a lower life expectancy than the generation before them.
Is this evolution or is this devolution?
You see we need to evolve the way that we practice medicine of aetiology not symptomology – the medicine that asks why, not only tells you what. This is personalised medicine, this is precision medicine, this is progressive medicine and actually if you take a step back, this is preventative medicine in its purest form. We have got to stop applying 20th century thinking to 21st century problems, we need to take back control, empower ourselves and re-educate ourselves away from our fear of disease and right back down the curve to optimal health. Because if we do, together, I genuinely believe that we can change not only our health, not only the health of our communities but maybe, just maybe, we could start to change the health of the entire world. Thank you”
— Dr Chatterjee