The Medical Model - the good, the bad, and the not so ugly

A photo of dozens of pills

Most people with autoimmune disease are following the traditional medical model. They have symptoms, they go to their doctor. If they’re lucky, they can get a diagnosis fairly quickly, and get started on some sort of medication – usually a combination of immune suppressants and steroids. Their disease progresses, and eventually they move up to more powerful medications and sometimes surgical procedures and chemotherapy. Sometimes, their disease goes into remission, and sometimes it doesn’t. Autoimmune medication works in a couple of different ways. Immune suppressants like methotrexate work to reduce the speed at which your immune system generates new cells, much the same way that chemotherapy works to slow the growth of tumors. By reducing the number of white blood cells, these immune suppressants slow down the immune system so it reduces the attacks on healthy, functioning tissues in the body. These drugs also suppress the body’s ability to fight off infections, so opportunistic infections can set in, and simple colds and flu can expand into debilitating events. Steroids like prednisone are often prescribed to calm inflammation. They work with the body to reduce inflammation and suppress the white blood cell response to tissues. Steroids are sometimes used to reduce pain and swelling of tissues, and can have side effects like weight gain, acne, headaches, dizziness, and thinning skin

Surgical procedures remove a portion of the body that’s being attacked – thyroid disorders are often treated with surgery. While this does stop the autoimmune attack, it also stops whatever function that organ performed. And, while this might seem like a good idea at the time, it can have wide reaching impacts because synthetic hormone replacements are just not as good as the ones your body makes by itself.

I’m not at all opposed to the medical model – even though it might seem like it sometimes. I am a fan of making informed choices, and often the medical model presents itself as the only choice. Doctors aren’t skilled in using complementary medical approaches, so they often don’t recommend them or go so far as to actively discourage them.

I believe that in addition to understanding the potential benefits of a treatment, you should understand how it works, and what else it might do in your body. Those are the details that are written on those tiny-printed inserts that come with your medications – that we tend to toss out, unopened.

But often, medicine is a great thing! And that leads me into the good news about medical approaches to autoimmune disease.

Sometimes, in cases like Hashimoto’s or Type 1 diabetes, medications are necessary, because there’s little you can do to modify your diet and lifestyle to boost hormones from organs that no longer function. For these people, medical approaches are lifesavers. They wouldn’t be able to survive without the key insulin and thyroid hormone that medications provide. How wonderful that we have created these medications! Also, if you’ve reached a point in your disease progression that you’ve got longstanding damage, scar tissue, or reduced function, a medical approach with steroids can make life easier for you with pain management, nutrient absorption, and reduced swelling of connective tissues. Having a great relationship with your doctor can take advantage of these benefits while minimizing the side effects.

Then, we have the bad news – a lot of people don’t have an awesome doctor who is willing to take the time to work with them, or they don’t have access to specialists, either because of where they live or because of their insurance and financial situations. These people end up with the ‘standard approach’ and typically find that they take the drugs, get marginally better, and have unpleasant side effects. They’re not sure why these medications make such amazing promises, but fail to deliver. And their doctor isn’t always well equipped to propose other solutions.

I know a lot of people who have taken the medical approach to managing their autoimmune disease, and for their purposes, they’re happy enough with the outcome. They accepted that their disease is a lifelong, life-limiting event that they’ll just have to get used to – knowing that it will diminish their energy, their mobility, and their ability to do the things they used to do.

I completely get this perspective. It is, after all, what we’re conditioned to do. Doctors are the medical experts, right? They went to school, did their residency, and have a white coat and a stethoscope. In following this approach, it is easy to believe there are no other real options, and I respect that. It is about doing the best you can with what you know, and I am always empathetic of anyone with an autoimmune disease that faces her disease, gets up in the morning, and pushes through another day.

I have clients who believe this model isn't their future. They know they can be better – not cured – but better. They know there are alternatives to medications. They are willing to take their health in their own hands and adjust their lifestyle to make a difference in how they feel. These people don’t necessarily reject the medical model, but they do look to see if they can stop the symptoms rather than cover them up with medications.

I’ll finish with the not so ugly news – there’s much research and clinical experience with these medications, and in many cases, patients can achieve remission for extended periods. This is wonderful news for people who are struggling with constant pain and discomfort. These drugs can be lifesavers for many people – and if they find a great doctor to help them manage and navigate the challenges of life with an autoimmune disease, then they’ll do well using the medical model.

So what do I recommend? I always create a customized strategy for each of my clients. That strategy includes seven different aspects of health – nutrition, movement, sleep, environment, stress, attitude, and joy. I believe that it requires attention and action in each of these areas to achieve true health. By taking steps toward strengthening your health in each area, you’re nourishing your body enough that the symptoms just go away. The medical approach is less directed at rebuilding the body and more focused on making the discomfort go away. I am always willing to work with a client’s doctor to make sure that our approach is coordinated and appropriate. Their doctor works to reduce symptoms for comfort and ease, and I work to build up their health and identify issues that are contributing to symptoms. Together, we can approach autoimmune disease from a whole-person perspective and take advantage of everyone’s expertise.

What approach are you taking? Is it working for you? Share your thoughts below.