Two recent articles posted in Brownstone Journal caught my attention. The first: “Political Psychiatry and the Genesis of the Trans Epidemic” by Max Dublin provided an exposé of the ways in which psychiatry combined with a fringe political group in ways that have had profoundly devastating patient consequences. Leave it to the pharmaceutical industry to then throw gasoline on the fire!
The other article: “George Washington, Father of the Country, Killed by Doctors” by Jeffrey A. Tucker provided a historical perspective of another medical modality, bloodletting, which helped no one, but killed many, except for the rare instance when the practitioner happened to be serendipitously dealing with a case of polycythemia vera. In fact, one could speculate that the reason bloodletting came into common practice was due to improvement of a patient that happened to be an early case of this disease!
The reason these two articles piqued my interest is that they reminded me that treatments for what I’ll call spurious illnesses are not confined to 21st century psychiatry or routine 18th century medical practice. I also thought it would be of interest to bring a perspective directly from the trenches; something that neither of the authors cited above can provide, since they were not trained as physicians.
Beginning about 25 years ago, shortly after ending my rural primary care practice as a Board Certified Internist, I began to recognize that from the 1960s through the end of the 20th century, there were a series of illnesses that I initially referred to as ‘fad’ diseases. Given that each of these diseases were in vogue for at least a decade (a bit too long to be a fad), and in an attempt to be more ‘woke,’ I now refer to these conditions as ‘meme’ diseases.
Back in the 1960s (when I was in junior high and high school), I recall underactive thyroid being a frequent explanation for fatigue and weight gain, generally in women. Of note, crude and very inaccurate measures of thyroid function first became available in 1960, and it took almost 20 years for reliable tests to come on the market. This did not stop physicians from prescribing thyroid replacement medications to millions of patients on the flimsiest of indications. My clinical experience tells me that very few people were helped, and a larger number were harmed.
An ‘echo boom’ of overdiagnosis of underactive thyroid occurred once thyroid stimulating hormone (TSH) testing became available in the 1970s. Many patients with normal thyroid hormone levels, but low TSH levels were found, and they were frequently placed on thyroid hormone replacement for what has been termed sub-clinical hypothyroidism.
In September 2021, I happened to see a Commentary in the American Journal of Medicine (AJM) addressing a study showing that treatment of patients with normal thyroid hormone levels, but low TSH levels was unwarranted, even in patients who had mild symptoms suggestive of hypothyroidism: “Don’t React to Symptoms in Patients with Subclinical Hypothyroid Disease” by Stuart R. Chipkin, MD and Joseph S. Alpert, MD.
It turns out that Dr Alpert, who has been the Editor-in-Chief of the AJM for a number of years, and with whom I have corresponded by email several times, is 10 years older than me, so he did his medical training during the 1960s, when the hypothyroidism meme was in full flower. When I presented my meme disease theory to him, which included hypothyroidism and the conditions to follow, I found his response to be simpatico with my framing, giving me confidence that my characterization of hypothyroidism treatment during the 1960s is accurate, despite the fact that my interest in medicine did not occur until a few years later.
When I attended medical school and trained in Internal Medicine during the 1970s, the confluence of the development of beta-blockers (specifically propranolol – Inderal), and the use of sonography as a modality for examining heart anatomy resulted in nothing less than an epidemic of mitral valve prolapse (MVP) syndrome diagnoses.
Millions of people, again mostly women, were placed on lifelong beta-blockers, until it was realized that in the overwhelming majority of those with this anatomic finding, it was merely a normal variant, present in up to 15% of the population. When I first went into rural private practice in 1980, I noted that of the hundreds of patients who had been placed on beta-blockers that I encountered, maybe one or two actually went on to develop valvular disease requiring surgical treatment.
Given the decades that these patients were on beta-blockers before surgery was needed, it is very likely that beta-blocker treatment did absolutely nothing to prevent valvular deterioration. Since all medications have side effects, some of which can be severe and even life-threatening, treatment of MVP likely caused more harm than good. Sound familiar? Today, anyone who has engaged in medical practice for less than 45-50 years has little or no awareness of MVP syndrome. It’s as if the condition had suddenly fallen off the planet!
Starting in the 1980s, chronic Lyme disease in association with Epstein-Barr antibodies became the latest meme disease in patients presenting with fatigue and other vague muscle or joint discomfort. This is not to say that chronic Lyme disease does not exist. However, the prevalence of true disease was only a tiny fraction of the number branded with the diagnosis.
I always believed that the conflation of chronic Lyme disease (which is the consequence of an infection by a spirochete) with antibodies to the mononucleosis virus (Epstein-Barr) was a deliberate fraud, given that almost 99% of the population will test positive for this antibody by the age of 20 While this diagnostic complex is still occasionally seen, by the early 1990s, it had largely left the scene, just as MVP syndrome had done a decade earlier.
Almost as soon as chronic Lyme/Epstein Barr diagnoses faded, it was replaced by fibromyalgia (most recently known as myalgic encephalomyelitis)/chronic fatigue syndrome (ME/CFS). Fibromyalgia has had name changes that, in my mind, were done merely to give this condition more physiologic legitimacy. For the same reason, I recall that Epstein-Barr would also be added to the syndrome.
Once again, there were (and are) people who legitimately have this condition, but similar to the other meme diseases, the true incidence is considerably less than generally stated. Any number of treatment regimens was prescribed for this condition, but it was my observation that more often than not, the treatments caused more harm than benefit.
In all of these meme diseases; (1) there is a known medical condition that could be cited; and, (2) the overwhelming majority of sufferers are women. With the exception of ME/CFS, which appears to have a more solid though poorly characterized pathophysiological basis, these meme diseases turned out to be phantoms that mysteriously disappeared (or to use the current ‘woke’ term, were ‘cancelled’). These conditions also represented examples of the treatment being much worse than the purported disease. An additional tragedy is that those few with a legitimate medical illness requiring compassionate care and appropriate treatment tended to get lumped in with the others, and too often fell through the cracks.
More recently, Long Covid (from infection; not the jab) can be added to this list of meme diseases. Early in the pandemic, the term was on everyone’s lips daily, while now, it’s rarely mentioned, indicating that either its prevalence was wildly exaggerated or almost everyone eventually recovered. Unfortunately, those suffering with this condition due to the jab (which I believe has much greater prevalence when compared to prevalence from viral infection) have not had such a benign course.
For the past couple of years, I have been saying to anyone who will listen that if a risk/benefit analysis of every pharmaceutical product approved since January 1, 2000 were to be performed (and we can even exclude the Covid jab from this analysis), the findings would be much less than favorable. Whatever happened to first, do no harm? Of note, a large percentage of these approved drugs are psychotropic medications, which should not be surprising.
Currently, vaccines are starting to be looked at in a more objective way, but the resistance is fierce. Let’s hope that a reckoning is at hand. If we can truly sort out what works from what’s harmful, maybe we can get the cost of healthcare under control, while simultaneously improving patient outcomes.
Finally, given the tyrannical influence of the pharmaceutical industry in driving treatment that the Covid response has exposed, it raises the question as to whether the pharmaceutical industry cut its teeth decades ago on the meme diseases.
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