Heretical Hypothesis, on Unexplained and Controversial Medical Syndromes

Originally published in Medium, April 2019, as a response to another article.

A heretical observation, from a retired tech person with no credentials whatsoever in this space, and who utterly failed in a Lorenzo’s Oil style effort in a related but highly controversial space in the late 1990s:

There are a lot of things going on in human bodies today which patients observe, physicians have no tools to deal with and frequently deny the reality of, and which cannot possibly occur given the basic theory underlying not just the practice of medicine but also medical research today. This basic theory is pretty much unchanged since Pasteur proved germ theory, the last big disruption.

I propose it’s time for new theory, as disruptive to medicine as germ theory was, which brings clarity of thought (and an end of denial) to a number of conditions which are very poorly understood and therefore controversial today. That theory will not fit neatly in the structures-and-functions world which came from the age of autopsies, nor will it fit in the infectious disease world developed after Pasteur’s groundbreaking experiment.

My heresy: one candidate for such a new disease model would be a hypothesis I stumbled over in the late 1990s, which is certainly wrong in the detail but provides a very different perspective through which some of these confounding diseases can be viewed. Although it would take a short book to explain this, the essence is:

(1) there is no magic blood/air barrier, just semipermeable membranes at the lung surface, the skin, and the digestive system which pass low molecular weight molecules/ions to the bloodstream. The “barrier” model has been a very useful approximation for a long time, but no longer holds given the changes to our environment and diet over the last 50 years.

(2) the circulating proteins in the bloodstream should be viewed not individually, but rather collectively as a system which takes those low molecular weight molecules/ions coming into the bloodstream, and either inventories them for later use in the body, or just captures them to keep them out of trouble (or more precisely prevent them from interfering in body processes including the correct operation of the nervous system).

(3) The liver strips substances from circulating protein binding sites for disposal via the bile. The kidneys dump low molecular weight substances which aren’t on binding sites to the urine. The immune system’s “complement” mechanism marks proteins which have things stuck to binding sites that haven’t moved in a certain amount of time (the old big city parking enforcer putting chalk marks on car tires comes to mind) and the immune system attacks any combination of circulating protein and hapten that’s been together too long. [Yes, the operation of the liver, kidney, and immune system are oversimplified to the extreme here.]

(4) A large dose of some molecule/ion, which the liver can’t clear off a binding protein in (speculation based on my experience) about two days, when the substance is ubiquitous, will trigger the immune system to attack the combination of that hapten on that binding site of that circulating protein, resulting in the lifelong absence of that binding protein, and ongoing use of liver resources to re-synthesize it and immune resources to re-destroy it together with the ubiquitous hapten. Note that this is consistent with reports of toxicological sensitization after an industrial accident, a concept which is very controversial because cui bono. It is also consistent with the unexplained elevation of immune system activity in patients who experience chemical sensitivity. Note that this process is statistical and the autoimmune attack on that binding- protein-cum-molecule/ion can occur from ongoing small exposures, one large exposure, or even a tiny exposure when the liver is busy elsewhere or just bad luck.

(5) After all of the individual’s genetically available (and actually used) circulating protein binding sites for that molecule/ion are all attacked, that molecule/ion is pretty much free to roam the body. One of the ways it can get into trouble is interfering directly with some body process. Another way is it can displace something important to the body on a different binding protein, which would be particularly vexing if that in turn led to an autoimmune attack there as well. (Picture what would happen to the body’s iron metabolism if ferritin or transferrin didn’t exist.) (I can pose hypotheses of how several very controversial conditions could occur if the binding proteins inventorying key neurotransmitters or ion channel ions went away, by analogy with what would happen if the little decoupling capacitors suddenly vanished off the motherboard of the computer you’re reading this on.) One could also get the errant molecule/ion stuck to some body structure as a hapten, then attacked by the immune system, leading to a known autoimmune disease.

…but I’m just an old heretic with no credentials, speaking a heresy which would get any physician drummed out of the profession the way Semmelweiss was for the high crime of suggesting that physicians wash their hands between patients…