Chris Kresser: That’s kind of a hard question to answer. I guess it depends on what you mean by “success,” but I would say eight or nine times out of ten we’re able to significantly help people. Does that mean that we cure them and get them to the place where they’re at 100 percent and don’t have any complaints or issues at all? No. I wouldn’t say we do that 80 to 90 percent of the time. There are certainly cases where we do that, though, and we get to a place where I ask the patient if they have any complaints, and they say, “No,” and I say, “OK, well, great. Have a great life and come back next year for a checkup, and we’ll talk to you then.” That happens pretty regularly at the end of a treatment, but there’s also a group of patients who get better, but they don’t fully recover.
I think what we’re learning now with epigenetics, and again, HPA axis is on my mind, and this is just one example, but I’ve just been reading some studies that suggest that early life events and fetal programming of the HPA axis can affect cortisol levels all the way through until the person is 70 years old. That’s kind of bad news in some ways because it means that epigenetic changes that happen even when we’re in utero and certainly when we’re really young, during early life, and even as adults, can cause changes that may not be completely reversible even later on with diet and lifestyle changes and supplements and things like that.
As a clinician, I feel like it’s important to understand that. It’s not an easy conversation, necessarily, to have with your patients, but I do feel like it’s important in some cases to help manage expectations. In some cases, patients might leave your practice because they might want to find someone who is going to tell them what they want to hear, which is that they can recover 100 percent and they’ll never have to struggle with what they’re struggling with again, but in my experience both personally as someone who has struggled with chronic illness myself and also treating kind of some of the sickest of the sick patients, sometimes the name of the game is supporting the patient, improving them as much as you possibly can and supporting them to live a long, fulfilling, and happy life. If you can get to that point, then I think you’ve done your job because total resolution and elimination of all symptoms is not possible in every case. If that’s the goal for the clinician and the patient in every case, then that’s probably going to lead to a lot of frustration and disappointment on both sides.
I’ve been writing and talking about this a little bit recently. Those of you who are on my email list have probably seen that the last several weeks or few months, actually, have been extremely stressful for me because of the mold situation and the move and not being able to see patients in my office and a whole bunch of other stuff, and some symptoms which I had not experienced for many years started to come back. It was just a reflection of what I’ve been talking about just now and also the impact that stress and HPA axis activation can have on our overall health. I think sometimes when we get sick there are changes that happen in the body that then make us predisposed to those kinds of things happening again in the future even if we are able to recover. Health is not a static process. It’s a dynamic process. Things are always kind of moving and changing in the body, and we always have to continue doing the things that keep us healthy or else we won’t stay healthy.
That was kind of a long-winded answer to your question, but I hope it got to the root of it.