Here is the full transcript of Rangan Chatterjee’s TEDx Talk presentation: How to Make Diseases Disappear at TEDxLiverpool conference.
Listen to the MP3 Audio: How to make diseases disappear by Rangan Chatterjee at TEDxLiverpool
Rangan Chatterjee – NHS GP
I can make diseases disappear. To be more precise, I can make chronic diseases disappear. You see, chronic diseases are the long-term conditions like type 2 diabetes, high blood pressure, depression or even dementia. And there is 15 million people in England who have already been diagnosed with a chronic condition; that means looking out amongst you now there’s probably about 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 pounds every single year and I’m standing here before you’re saying it, I can make these diseases disappear.
See, I’m not a magician and what the Americans call an MD, that’s not a magical doctor. That’s a medical doctor or what I call a mere doctor. You see the reason I can make diseases disappear is because diseases are just an illusion, diseases are not real. In fact, diseases don’t really exist at least not in the way that we think they do.
So 15 years ago, I qualified for medical school and I was wearing — I was full of enthusiasm, full of passion, ready to go out and help people. But I felt like there was something missing, I started as a specialist, I moved from being a specialist to becoming a generalist or GP. And I always got this nagging sense that I was just managing disease or simply suppressing people symptoms.
And then just five and a half years ago came the turning point for me. See, five and a half years ago, my son nearly died. My wife and I, we were on holiday in France and with our little baby boy and she called out to me, 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 and my wife said, “Come on, we’ve got to get to hospital.” So we rushed there, 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. Then he had two lumbar punctures because they thought he might have meningitis and he stayed in a foreign hospital for three days.
And 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 has stayed with me and it’s still here today that changes you. So I started reading, 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 I thought: hey, this makes lot of sense to me. So I started applying the science. I started applying it, first of all, on my son, I saw the amazing benefits. So that I started playing it with my patients but do you know what happened? People started getting better, really better.
See, I learned how to resolve the root cause of their problems rather than simply suppressing their symptoms. Just over a year ago, I had the opportunity to make a series documentary for BBC One where I got to showcase this style of medicine. I’m going to tell you about one of the patients — a thirty-five-year-old Dotti, lovely lovely lady but she was struggling with her health, weight problems, joint problems, sleep problems. See, despite Dotti’s best efforts, Dotti was unable to make any sustainable changes.
So I went into Dotti’s house and in the first week I did some blood tests and I diagnosed her with type 2 diabetes. Six 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.
Okay, the top right we’ve got disease, the bottom left we’ve got optimal health and we are always moving up and down that continuum. Take Christmas, New Year, for example, right, we drink too much, we eat too much, we stay up late, we probably start to move up that curve. But if we recalibrate in January and February we start to move that down it again. We get involved in medicine and give you a diagnosis of a chronic disease here but things have been started to go wrong back here.
See, when I met Dotti, she was up here, she had a disease. You see, you can think of it a little bit like a fire that’s been burning in Dotti’s body for years; it’s getting bigger, it’s getting bigger, it’s finally raging out of control at that point. I can say hey Dotti, 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 an acute disease and chronic disease are two different things. Acute disease is something we’re pretty good at as doctors, we’re good at this. It’s quite simple. OK, you have something like a pneumonia, that’s a severe lung infection. So when you’re alone you have the overgrowth of some bugs, typically the bacteria. We identify the bacteria, we give you a treatment, typically an antibiotic and it kills the bacteria; bacteria dies 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 was out of control, right, 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 is 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 will 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 is becoming more and more intolerant to certain foods. At the moment, Dotti, your body does not tolerate refined or processed carbs or sugar at all.” She’s got to cut them out.
So what does that do? It stops pouring fuel on Dotti’s raging fire but then we’ve got to work out, well 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 the bottom left in optimal health like all of us in here, and you have a breakfast, let’s say, a sugary bowl of cereal, 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 could give it a little bit like alcohol, the very first time you have a drink, what happens — you have a glass of wine, one or two sets maybe half a glass, you’re tipsy, a little bit drunk and as you become a more seasoned and accustomed drinker, you need more and more alcohol to have the same effect; that’s what’s going on with insulin. You need more and more insulin to have the same effect but that insulin itself is problematic and when the insulin can no longer keep your sugar under control, at that point we say oh, 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? There’s many different things. It could be a diet, it could be that your diet for the last 10 years has been full of processed junk food, that could be a cause. But there’s something else. What if it’s the fact that you are chronically stressed, work stress, emotional stress, perceived stress. For me it’s just seeing my email inbox sometimes, that’s a stress. 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. See, in some people one night sleep deprivation can give you as much insulin resistance a six 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 microbiome? See, 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 when it gets in your blood it causes insulin resistance.
You see, the problem is there are many different 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 six weeks after I met her, she no longer had the disease. There was something else completely unrelated about depression. You see, one in five people are going to get depression at some point in their lives.
So what is depression? Some blood test, the depression, so scan depression — depression is simply the name that we give to a collection of symptoms but what causes the depression? What we know that many cases of depression are associated with something called inflammation. Now this isn’t the same information as if you trip up, you sprained your ankle, it gets ready, it’s 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.
King’s College London three 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 antidepressants. Take a step back it sort of makes sense, doesn’t it? Because an antidepressant 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.
See, what causes the inflammation? Well your diet plays a part in that, your stress levels play a part. Chronic sleep deprivation, physical inactivity, a lack of exposure to the sun which gives you vitamin D, disruptions in the gut microbiome, see there are many different things, if we do not address the cause, we’ll never get rid of diseases. Diseases are the symptom.
About something else — about Alzheimer’s disease. See, we’re all living longer, aren’t we? We’re scared — we’re scared that as we live longer and as we live older we may have to live with a devastating consequences of things like Alzheimer’s, so many of us in here have experienced that ourselves, our family. It’s a heart-wrenching condition and we the doctors, we’re scrambling around, and we’re trying to find the cure of it.
A professor in San Francisco, Professor Bredesen was actually demonstrating that you can cure dementia. He’s shown that you can reverse cognitive decline in his patients with dementia; and how is he doing that? One thing he’s not doing, he is not saying, well all these patients in my office have got dementia, Alzheimer’s disease, what is the cure? He’s going the other way; he’s saying with all these patients, let’s say ten 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 these patients 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. It’s looking at what is causing this disease in this individual patient is totally different.
So what factors is he looking at? He’s looking at their diet; he is looking at their stress levels, their sleep quality, their physical activity level, their exposure to environmental toxins etc etc etc, as they start to sound a little bit familiar. See, what if all these seemingly separate diseases actually out there share common root causes. See, 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 basically interact with your genes and determine how your genes are expressed whether you want an optimal health, whether you have a disease, 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 pounds a year, just a 1% saving that would be 200 million pounds, 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. We need the medicine of etiology, not symptomatology, the medicine that asks why not only tells you what; this is personalized medicine, this is precision medicine, this is progressive medicine. And actually if you take a step back, this is preventive medicine in its purest form.
We have got to stop applying 20th century thinking to 21st century problems. We need to take back control and power ourselves and we 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.