In my previous article, I covered 6 signs that your doctor may be blundering with your health. Here's the final six:
7. He* says your mineral status is good on the basis of serum levels
Again and again, I spot classic signs of magnesium insufficiency, to which the client says, "my doctor ran a blood test last year and told me that my magnesium levels were good." Again and again, it turns out that the doc ran a serum blood test.
This test cannot tell you about your magnesium status because, in short, your kidneys always maintain serum levels at the expense of all other cells. So the cells may be starving, but the concentration of magnesium in the bloodstream remains constant. Disturbances to these electrolyte point to problems with the kidneys, but are useless to determine your mineral status. If you want to know the cellular level of magnesium (or any other mineral), measure it in the cells with a Red Blood Cell test. This is hardly cutting-edge nutrition.
8. His response to a bad reaction to drugs is to maintain or increase the dosage
You would think this one would be quite simple. If you had spent years without rashes, started taking a new item and then looked like a victim of contagion within a few hours, you may be wise to consider if this novel pill is causing a reaction.
Now even good doctors can prescribe a drug or a supplement that triggers a bad response. After all, there are 74 trillion cells in the human body and many organ systems. Unexpected reactions happen. Good practitioners recognise this and make allowances for this. They don't say 'it's probably just your body getting used to the medication'.
9. He thinks that anti-depressants are the answer to your fatigue
Seven out of every 10 clients I see with adrenal issues have either taken anti-depressants or have been offered them. Even though all of them presented with primarily physical symptoms, mind-altering medication was repeatedly the first-choice treatment. Never were their serotonin levels tested before the prescription was offered.
Many doctors bemoan energy medicine but then prescribe anti-depressants without running a single test. Without asking a single question about your diet or omega 3 intake. Without discussing your sleep for a single second. Without ever talking to you about your exercise habits.
SSRIs alter the circuitry of your brain and many patients experience a tough time in discontinuing the medication. Often, serotonin levels have nothing to do with the symptoms; literature supports many different models of depression. Wouldn't it make sense run a test before modifying your neurochemistry?
10. He refuses a test on the basis that 'we ran that test two years ago'
Although it defies belief, this was exactly what a doctor said to a client of mine not too long ago. She had undergone a thyroid test in 2010 which showed a TSH of 3.1 (which astute readers will register as worthy of further investigation). Two years later, she understandably wanted to check if this had become more of an issue.
A statement like this totally disregards the dynamic nature of the human body, an incredible machine made up of inter-connecting systems in a constant state of flux. When the right (or wrong) environment is applied, significant changes in thyroid function can be measured in a matter of weeks.
11. He says, "I haven't actually checked the results yet, but I'm sure they're fine"
I once heard this. I was working with a top West End production company and had come on a conference call to discuss my recommendations for their leading lady. One of the other 'team members' sitting in was the company doctor, a grey and torpid man approaching his third decade with the firm. We had just brought up the issue of hormonal balance when he uttered this immortal line, then went on to say, "even if the results show a problem, I won't take any action".
Nothing really needs to be said here other than that, if a test is worth running, it's worth reading before making an assessment. And yes, last I heard, this guy was still stealing a living in Theatreland.
12. He refuses to take action because your test results are within the reference range
Although this is an obvious mistake, it's definitely the most common. Reference ranges are initially calculated by measuring the population at large, then taking both the top and bottom 1.25% to create the 'high' and 'low' range. This range is then modified on the basis of scientific discoveries or, more likely, health politics. This often leaves us with some huge reference ranges that actually include various levels of disease.
An example of this is serum cortisol. This stress hormone stands out as one of the most influential in the body, affecting every organ system. The reference range runs from 180 to 550nmol/L, meaning you can literally have 3 times the level of cortisol than your neighbour has yet both of you will be considered 'just fine'. Equally, a man with a testosterone count of 9.9 nmol/L gets treatment but one who comes in with a score of 10.1 is dismissed. Both have less than half the testosterone they should, yet only one is taken seriously. Something isn't right here.
Reference ranges are guidelines only and often have very little bearing on optimal health. If you want to know if your doctor is fobbing you off, ask him what he considers the ideal result to be. A competent doctor should have a specific figure in mind and will never hide behind these poorly-tabulated definitions on what's normal and what's not.
Summary
For better or worse, the doctor-patient relationship has changed forever. The information available internet has a big role to play in this but much of it must be taken with a pinch of salt. It is the doctors that have served their time 'in the trenches' and it is their wisdom - yielded from years of experience - that can allow you to make full use of the information out there.
Of course, years in the frontline only counts for something if the doctor in question has used this time to refine his trade, gather experience and learn from his patients. The list outlined above should tell you whether he has done so.
*as per Part 1, I will be using the male pronoun for the sake of fluid writing.