Rule: The multi-hit a-causal model of disease
Exception: The one-hit causal model of disease, which most people view as the rule and some view as the rule with no exceptions.
Complications: Sometimes deficiencies, a type of “hit” (see below), help with dread diseases. Example: low red blood cell lifetimes (due to sickle cell anemia, any of various thalassemias, G6PDH deficiency, other genetic deficiencies, and all other types of anemias, including iron deficient anemia) increase the odds of survival to at least the reproductive age against the dreaded malarial parasite. Nature is incredibly and intrinsically complex – a deficiency is not always the worst thing in the fight for life and reproduction; an excess of a toxin is not always the worst thing in the fight for life. Everything depends on other things, on the exact conditions. Nothing is simply good or bad, especially when survival is at stake.
“The cause of the effect” is a succinct definition of the causal, one hit model of disease and it seems to have some applicability as the exceptions to the rule.
A possible exception to the rule: Vitamin C deficiency alone appears to be completely responsible for the symptoms of scurvy and high dose vitamin C alone can completely reverse all of the symptoms of scurvy.
However, I think this is a bit of medical gerrymandering. There are a lot of scurvy associated symptoms that are not considered manifestations of scurvy. These are not curable by adding high dose vitamin C. What is curable by adding high dose vitamin C are just those symptoms attributable to vitamin C deficiency. In other words, scurvy is caused solely by vitamin C deficiency by definition, and by definition, scurvy is curable by high dose vitamin C alone.
A person eating only pizza will develop scurvy (the small amount of vitamin C in the tomato sauce is basically obliterated by high temperature cooking) and he can be cured of scurvy for the rest of his life by taking a dose of vitamin C every day, but he will not live healthily the rest of his life if he does stop this pure pizza diet. Rather, he will in time develop other deficiency diseases, each of which has a contour of associated symptoms that are not directly addressable by taking single supplements.
As I have argued before, it is impossible for anyone to be deficient in just one nutrient, given that there are thousands of unique sites in the human body and thousands of important substances in each of those sites, each of which has an optimal level, and any one of which can be in either excess or in deficiency. So with millions of measurables, it is simply impossible to have no more than one deficiency (to be below the optimal level) in just one location in the body. Simply impossible. A person develops scurvy by not supplementing and by avoiding entire food groups and thus develops multiple nutrient deficiencies that characterize such poor dietary choices. A person with scurvy and scurvy-associated symptoms can normalize his health only after adopting a sensible diet, if even then.
The multi-hit model is a-causal because the causal model is a one-hit model, and the multi-hit model necessarily involves two or more hits to the same target. This model assumes that our animal ancestors and early hominids went through sufficient rounds of selection to be generally resistant to single hits, provided the hits are not overly aggressive.
A hit may be either an excess or a deficiency in a particular site, including of course nutrient deficiencies and deficiencies in our defense systems.
So for example, most of us are very tolerant of low level mercury or low level arsenic toxicity (types of modest excesses) because we have adequate defenses (that is, no obvious deficiencies in our defense systems) against higher levels. But someone whose defenses are compromised may succumb to disease with just a moderately toxic dose.
This may be happening with certain kids who are getting rather closely spaced multiple doses of vaccines, which normally contain at least three toxins, though each is at a low level. The vaccine compromises the health of only those kids with a serious deficiency in our natural defenses against one or more of those toxins, potentially aggravated by too much of a particular toxin. Unless the authorities are looking for it, they might miss such toxic reactions. The vaccines harm the most vulnerable kids: those with the weakest defenses against one or more of the toxins and those who already had the highest levels of one or more of the toxins.
Think of kids with the highest levels of mercury in their bodies, who also have the weakest defenses against mercury poisoning (one reason why their levels got so high in the first place), who are in fact already struggling with subclinical mercury toxicity, and who then receive a closely spaced series of vaccines, each of which has a dose of ethyl mercury. Not a lot of kids, but a small cohort of highly vulnerable kids. To be able to detect these kids in a large pool of non-vulnerable kids, the authors of studies must classify the kids properly and make basic measurements of all of these parameters. This has never been done right and it probably will not be done right for some time to come. It may be easier to start with kids who develop autism shortly after a series of vaccines.
Here are more examples:
- The causal model is so ingrained in human thinking, as Kant noted, that even when the causal model is obviously wrong, people still hold it to be true. For example, the CDC estimates that there are 55 million cases of infectious diarrhea in the US each year and 3,000 deaths that are caused by these infections. Clearly, however, these two facts define an a-causal model in which the infectious agent is just one hit, one that challenges our defenses, and clearly the challenge is easily beatable, with a death rate of only 0.0055%. Weakness in the defenses of the victims, the second hit, is what proves fatal. Among the weaknesses noted are frail health (the victims are often very old), underdeveloped immunity (children under six), immunosuppression, long-term use of antibiotics, and the use of acid blockers. Not even considered, but worth a look, are potassium deficiency, a deficiency of fat in the diet, and deficiencies in hygiene (bio-amplification from re-infection).
- Cigarette smoking plus a heavy dose of asbestos constitute an imbalanced toxic load on the lungs, and greatly increase the odds of getting mesothelioma, much more than cigarette smoking alone or heavy exposure to asbestos alone.
- Contrary to common belief, alcoholism alone is usually not enough to yield cirrhosis. It takes a second insult to the liver in the form of either hepatitis (especially hepatitis C) or malnutrition (which is often secondary to an excessive alcohol consumption, and for two different reasons: (1) the inflammation in the digestive tract compromises nutrient absorption and (2) detoxification reactions consume nutrients). There is an entire population of heavy drinkers who are also hearty consumers of rich and nutritious foods and who rarely get cirrhosis – the bon vivants.
- Cancer is a multiple hit disease, and involves both genetic hits (often requiring hits in both copies of a critical gene), metabolic deficiencies, and immune deficiencies.
- Speculative example: could IBD be due to 2 hits (each of which has other hits) – an inflammatory hit plus a hit to the immune system? There is a baseline of gut inflammation in all humans due to uncontrollable factors, including simply the ingestion of food lectins.
- Above that there are some serious inflammatory substances that we ingest, some of us in massive quantities. About 17 million Americans (12% of adults) abuse alcohol. This alcohol abuse is also a hit to the immune system and a hit due to multiple nutrient deficiencies that develop, as noted above. In addition, though I have not seen this studied, heavy alcohol consumption should increase the yeast burden in the gut because as a group yeast are more resistant to alcohol than bacteria.
- Another hit to the guts involves a direct hit by alcohol to the immune system. Again, there is a huge background to this immuno-inflammation, including of course the food we eat and all of the food allergies and over-reactions by our immune system. But on top of this is the 15 million Americans (about 10.6% of adults) who take acid blockers. This also constitutes a deficiency type of hit to our defenses by reducing total nutrition (the expected hits, some of which have been at least noted in the literature, include calcium, magnesium, iron, B12; and a second wave of deficiency hits, affecting potentially all nutrients somewhat, when the small intestine becomes overgrown with bacteria or fungi that were not killed by stomach acid plus free fatty acids).
- Given sufficient free fatty acids, proper acidification of the stomach kills most pathogens that we consume, and allows mostly acidophilus bacteria and acid tolerant yeasts to pass through. The former include beneficial bacteria and I assume the acid tolerant yeast are likely commensals. However, when we allow acid-sensitive pathogens to pass through our guts, we can expect a vigorous battle with our both our innate and adaptive immune systems, constituting a second inflammatory hit in the development of IBD.
- According to CDC, only 1-1.3 million (approximately 0.4%) Americans have IBD. As noted above, 5.7% of Americans (17 million/300 million) drink heavily (multiple hits to the guts) and 5% take acid blockers (multiple hits to the guts)? If these are independent events, we would expect 0.3% of Americans do both, and we would expect 0.3% of Americans to suffer the consequences of doing both, which may or may not include IBD. This is close to the 0.4% prevalence of IBD, but of course this is an oversimplified outline of inflammatory insults to the gut. What else is involved? A lot of things.
- Unfortunately, I have seen but one study of IBD and alcohol consumption and it was based on surveys. If man were more truthful, this might actually count for something. Man is not – I would run a sequence of random urine samples from people with IBD and people without, and look for a complete spectrum of compounds in their urine, each normalized to creatinine. I would create categorical variables (say dividing populations into tertiles or quartiles and contingency tables, and then use the Chi Squared Test of Independence to look for variables that correlate to IBD, and everything else I was testing.
- Would love to know what correlates with depression – I suspect alcohol consumption, the taking of acid blockers, and yeast overgrowth biomarkers may correlate with degree of depression because alcohol itself and the other yeast byproducts both have depressing effects on the CNS.
- Yeast overgrowth and chronic fatigue syndrome are probably also linked – a person with yeast overgrowth should feel a bit depressed, a little spacey, a little tipsy, and a little hung over at all times, but especially after high carbohydrate meals and snacks have been converted to alcohol in the gut.