Marty Makary MD, ‘Blind Spots,’ Part 2

One week ago, I wrote a post about the mind-blowing discoveries of Marty Makary, M.D. concerning the medical field and its reliance on alleviating its own cognitive dissonance, to the detriment of the public and medicine. I promised, however, that I would write a more comprehensive book review of Blind Spots, because I want every person who hasn’t read the book to learn some life-changing information — and maybe even be motivated to read his book. It has changed my life, and will certainly change the life of many people.

I don’t plan to even try to cover everything in the book, but I’ve chosen to focus on key subjects: those that may lead potentially to serious illness or death. I’m not trying to be overly dramatic, but some of the decisions that have been made in the past because of a lack of good information are frightening. There are doctors who still follow these faulty guidelines.

The key areas I want to draw your attention to are allergies, hormone replacement therapy, the microbiome, ovarian cancer, cholesterol, obesity, and diabetes. In every case, at least one fact provided me with new information. I am providing only a brief description of each topic, and I encourage you to read the book for an in-depth analysis.

Allergies: The most devastating allergy for many families is peanut allergies. Doctors had essentially been propagandized to believe that peanuts could put babies at risk. As a result, parents avoided giving their children any peanuts, which prevented them from developing any immunity to them:

Avoiding peanuts had been the correct answer on medical school tests and board exams, which were written and administered by the American Board of Pediatrics.

Eventually, two doctors, named Lack and Combs, discovered the illegitimacy of this diagnosis and favored tiny exposures to peanut products at first:

Extrapolating the principle to other potential allergens, Dr. Combs also encouraged the early introduction of eggs, milk, strawberries, and even early exposure to dogs and cats. As a result, the children in his practice rarely developed an allergy to these things, and when they did, it was mild.

Hormone Replacement Therapy: A flawed study claimed there was a relationship between HRT and breast cancer, and untold numbers of women stopped their HRT treatment. Not only is there not a connection, but the benefits of this kind of therapy, usually taken within the onset of menopause, are impressive:

Women taking estrogen have a 35% lower incidence of Alzheimer’s. That’s according to a University of Southern California study of more than 8,800 women.

Danish researchers randomized 343 women in early menopause to receive HRT versus placebo and followed them for up to 15 years. They found that taking HRT for even just two to three years reduced the risk of cognitive impairment by 64%.21 Wow.

Heart disease is the leading cause of death in American women. HRT reduces that risk by about 50%.

The microbiome: This system was not part of any of my health discussions with doctors:

The microbiome is one of the least understood organ systems in the body, yet it may be central to our health. It’s a garden of billions of different bacteria, fungi, and other organisms in our gut that normally live in a healthy balance.

Overuse and early ingestion of antibiotics can damage the microbiome. (By the way, those of you who think that probiotics help may be wasting your time.)

I couldn’t help but be amused by this comment by Dr. Makary:

Microbiome research can be done at a fraction of the cost of drug development. This is not the Manhattan Project or the lunar landing; it’s just basic research.

Ovarian cancer: One of the most shocking revelations was about ovarian cancer, a deadly cancer often identified too late to save the patient. Researchers finally discovered that women were not suffering from ovarian cancer, but from fallopian cancer. All these many years, ovaries were needlessly being removed when cancer was growing on the fallopian tubes. Some doctors have still not gotten the message and are removing ovaries, which causes a woman to lose the benefits from a small source of hormones.

Cholesterol: For all of us who are taking statins, this might come as a shock:

Study after study has failed to demonstrate the connection between dietary cholesterol and heart disease, or between the cholesterol in your diet and the cholesterol levels in your blood.

In fact, every cell in the body has a wall that is made out of cholesterol. Cholesterol is also the building-block precursor for estrogen, progesterone, testosterone, and corticosteroids—critical hormones for normal physiology and health.

Obesity and Diabetes: Our country has an alarming number of people who would be identified as obese, as well as afflicted with diabetes. Yet how many of us religiously shop for low-fat foods:

But then epidemiologists began to look at obesity and diabetes trends. They noted that after each major low-fat recommendation push, obesity and diabetes in the U.S. accelerated.

When confronted with surging obesity rates, doctors dismissed the possibility that it could be a consequence of eating low-fat food that happened to be loaded with more sugar.

They noticed something peculiar: Some patients with high cholesterol would have no blockages and, conversely, some patients with low cholesterol had severe blockages. They began to question conventional wisdom.

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As a result of these discoveries, I’ve come away with mixed feelings about the medical industry. When should we trust their diagnoses? Are practitioners drawing conclusions independently or based on “conventional wisdom”? To try to answer these questions, we need to find doctors who we believe we can trust, and who consider these final points that Dr. Makary raised with his colleagues:

We must hold high the scientific method and recognize our biases. As Dr. Festinger pointed out, we all have a natural tendency to dismiss information we simply don’t like. Calling an intervention a ‘parachute’ when it deserves a proper study is one way smart people make bad policy. Second, sometimes in medicine, the right answer is ‘I don’t know.’ Third, health professionals and the public must know which recommendations are based on opinion and which are based on robust medical evidence. Fourth, the best way to fight bad ideas is with better ideas, not by canceling scientists. Finally, scientists and business innovators in medicine alike should be inspired to think differently and challenge deeply held assumptions in the field.

Thank you, Dr. Makary, for your dedication to your patients and to medicine.