How Do Constitutional Archetypes Determine the Correct Dose of a Treatment?

While pharmaceutical drugs can sometimes be remarkably helpful, because of how frequently I observe them harm patients, I am inherently hesitant to use them. In each case where they injure someone, I’ve found that typically one or more of the following is at play:

Every physician I know has specific maxims they follow in their medical practice, and throughout my career I’ve taken many to heart espoused by the most talented physicians I’ve worked with. One of those was:

“I always dose everything.”

In turn, I believe that much of the benefits and harms of each therapy (be it a conventional or holistic one) are the result of the dose that is used. In turn, I frequently observe drugs I do not like (due to their inherent toxicity) greatly benefit patients when they are instead provided at a much lower dose to patients and observe “safe” natural or alternative medical therapies (which I like) harm patients because they were given at too high of a dose.

Low Dose Naltrexone

Your body produces endorphins, which are peptide hormones that activate the opioid receptors in the body and thus function as natural pain killers which create positive feelings for the recipient.

Many of the activities we associate with “feeling good” (e.g., exercise or intercourse) are associated with an endorphin release, and it has been observed that many activities necessary for the survival of our species also are (e.g., breastfeeding causes endorphins to be released and travel into the feeding infant).

Opioid drugs hijack that system and stimulate it at a much higher dose than what the body naturally experiences. This can be both helpful (since that can address severe pain) but also very problematic as the positive experiences opioids create can rapidly become addictive.

That addiction, in turn, is a product of the body recognizing its opioid receptors are being overstimulated by those powerful external opioids and it then creating a compensatory down-regulation of that system to avoid an overstimulation.

Once this happens, the natural endorphin production is no longer sufficient to meet the body’s needs and significant withdrawals occur once opioids are no longer consumed and artificially stimulating that system. There are two important implications of this process.

First it helps to explain why so many drugs (such as those which work on systems besides the opioid receptors) are to varying degrees addictive and why their benefits diminish over time as they are taken chronically.

Conversely, this is why it often works much better to give a drug or supplement intermittently so its signal can clear from the body before a new one is given and in many cases, (such as when treating the cell danger response), pulsed dosing is essential for rebuilding the body’s homeostasis.

Secondly, it raises the question. What if you did the opposite? Because of how addictive drugs can be and how much damage certain addictions create for society, a lot of work has gone into developing protocols for addressing drug addictions.

One approach has been to develop medications (such as naltrexone) which block the body’s opioid receptors, so that when an exogenous opioid (e.g., heroin) is taken, it cannot trigger a pleasurable response, and hence over time causes the addicted individual to gradually lose the desire to consume the opioid.

Note: Naltrexone is often used for other addictions, for example it has been found to be remarkably helpful for alcoholism.

In the 1974, Bernard Bihari MD became New York City’s addiction commissioner (heroin addiction was a huge problem at this time) and ever since was involved in the work being done to combat drug addiction. In 1984, naltrexone was developed, and because of his position, Bihari had followed naltrexone’s development closely, which in turn had caused him to make note of the fact naltrexone had been found to triple the endorphin levels of participants who received it.

A few years before naltrexone hit the market, AIDS had emerged in New York, and since Bihari was seeing many of his addicted patients begin to die from AIDS, in 1985 he switched his focus from addiction to AIDS. Since endorphins were known to regulate the immune response (e.g., injecting them significantly increased immune function in animals) this made him wonder if naltrexone could be used to save the immune-suppressed AIDS patients.

However since naltrexone was difficult for many of his addicted patients to tolerate (as they could not handle the opioid withdrawals it created), Bihari decided to see if a lower dose than 52mg could still achieve a meaningful increase in the body’s endorphins. Before long, he found that 3mg worked as well as 52mg but did not create those significant withdrawals.

He then proceeded to test it on AIDS patients and found that (if administered at the correct time), it dramatically improved the course of the disease. Unfortunately, like many other promising therapies for AIDS, it was given a cold shoulder so Fauci could push the toxic drug AZT onto the market.

Before long, Bihari also discovered low dose naltrexone therapy (LDN) also worked quite well for certain cancers (many cancer treatments essentially work by up-regulating the immune system). Furthermore, he also observed that in both cancer and AIDS, the body’s endorphin levels were about 30% of normal — which may explain why LDN helps so much for those conditions.

Since that time, LDN has also been found to be quite helpful for other conditions, particularly chronic pain and autoimmune disorders (e.g., those caused by the COVID vaccines).

Since a therapy like this threatens numerous pharmaceutical markets, there has always been an institution resistance toward sanctioning the research or use of LDN — however patient advocates have been able to and as time moves forward, more and more evidence of the benefits of LDN have accumulated. In short, LDN illustrates how differently a drug can behave at a different dosage.

How Is a Dose Chosen?

Typically, for a drug to “work,” enough of it has to be present in a patient to trigger the desired effect of the drug. Exactly how much does that varies significantly as:

Conversely, the toxicity of a drug can widely vary (e.g., for all of the same reasons listed above).

Note: The chronic and more subtle toxicities of a drug receive minimal consideration when dose dependent adverse events are being evaluated.

When drugs are designed, the drug companies thus have to decide what constitutes an appropriate dose for the product. Ideally they want to have minimal side effects while simultaneously having the majority of patients experience the intended effects of a drug. In some cases this is fairly easy, as the toxic dose is much, much higher than the effective dose, while in other cases it’s challenging as the two are very close.

This concept is expressed by the idea of a “therapeutic index,” which quantifies how far the effective dose of a drug is from the toxic dose. With drugs that have a wide therapeutic index, it is relatively unlikely someone taking them as prescribed will experience a known toxicity toxic event, while with drugs that have narrow therapeutic windows, this is much more likely.

For this reason, drugs with narrow therapeutic windows (e.g., chemotherapy — which needs to kill most of the cancer cells without killing too much of the normal cells) are often given in a supervised setting where the exact concentration of the drug can be controlled and side effects can be monitored for.

Note: One of the major problems with the mRNA technology is that since the mRNA doses varied so much lot to lot (as a result of their rushed production), and the time the mRNA persisted in the body also greatly varied, it was not possible to use the existing laws of toxicology to determine what a toxic dose of the COVID vaccines was.

Because it is often impossible to have an effective dose which is low enough that it does not also create side effects in some of the recipients, drug companies typically err towards the higher dose and do their best to downplay the toxicities that occur in their trials. This for example is why in drug trials, the drugs are often only tested on the healthiest members of the population who are the least likely to experience adverse reactions to the medications.

Note: Often when a drug is first launched (especially if it is a new type of medication) the company will use a lower dose of it both in the trials and once it enters the market (as that prevents an initial wave of injuries which may cause the drug to get pulled from the market).

However, once the drug is approved and has become something doctors and patients feel should always be available to them, the dose of the drug and the number of eligible who are eligible to receive it is increased, as at that point, the resulting wave of injuries are unlikely to be recognized or motivate the FDA to upset the public by withdrawing the drug from the marketplace. Later in the article, we will review how this happened with Viagra.

Since the FDA prioritizes signs of efficacy over ensuring safety, as best as I can tell, focusing on “efficacy” has become the industry standard. For example, a key metric the FDA uses to determine if a vaccine should be approved is the antibody response it generates in recipients.

Since different people respond differently to the same vaccination, and there is no penalty for an excessively high antibody response to a vaccine, vaccine manufacturers often create products that overstimulate the immune system.

Prior to the COVID-19 vaccines, one of the best examples of this was the HPV vaccine Gardasil. When it was being designed, Merck realized that it was difficult for the body to develop an immune response to the HPV antigen (which I suspect was due to the body being designed to resist developing autoimmunity and the vaccine’s antigen having similarities to human tissue). To solve this problem, Merck used a much stronger adjuvant.

This “worked” and ensured the vaccine reliably produced an immune response in its clinical trial subjects — but also caused the vaccine to have a very high rate of severe side effects in those who received it. However, since the FDA prioritized “efficacy” this trade off was accepted and ever since then the FDA and CDC have worked hand-in-hand to cover up the immense number of injuries that have been caused by the HPV vaccine.

Note: Many recognized from the start that having a single highly toxic protein (in a rapidly mutating region of the SARS-CoV-2 virus) be mass-produced within the body would lead to a large number of injuries and the virus rapidly mutating to a strain not covered by the vaccine. As such, a longstanding debate has existed over exactly why Pfizer, Moderna (and the FDA which approved their vaccines) chose what was clearly a bad design for the vaccines which would be pushed upon the world.

The least evil explanation I have come up with is that all the vaccine companies knew that whoever was the first to produce a vaccine that appeared to create immunity would get exclusive rights to a massive market.

Pfizer and Moderna in turn prioritized what they thought would be the fastest and most reliable way to do that (using the vaccine to mass produce the most immunogenic part of the virus) in the body, knowing full well that the FDA, in line with its past actions (e.g., towards Gardasil) would ignore the evidence of harm created by this strategy.

Similarly, a case can be made that the reason the experimental mRNA technology was chosen (despite its innumerable safety concerns) was simply that of the existing vaccine platforms, it had by far the shortest production turnaround time.

For context, Fauci and others had worked for years to develop the mRNA platform so that it could be used to make flu shots closer to the flu season, as the existing method required production to start long before it was realistically possible to know what the circulating strains would be (and hence what to put in the vaccine — which is why flu vaccines often have the “wrong” strain each year).

Large Double Blind Trials

At this point in time, we hold the belief that for a clinical trial to be valid, it must have a large number of people enrolled in it, and be double blinded. I would argue the following is true about those trials:

Note: My own belief is that large magnitudes of effect do not require large trials to be detected (which has been repeatedly shown by small studies observing those effects that are eventually confirmed by large blinded trials and then become the standard of care). Since a therapy at least in theory should have a large magnitude of effect, this calls into question the assumed need for prohibitively expense trials in order to adopt a new therapy.

The above also helps to explain why a ton of money is frequently spent on those trials, yet they often fail to detect clinically significant adverse events (e.g., consider the countless severe injuries that whistleblowers from the COVID-19 vaccine trials revealed were covered up by the vaccine manufacturers).

Likewise, financial conflicts of interest help to explain why more and more pharmaceuticals are pushed onto patients despite them not appearing to provide any significant benefit to the majority of those receiving them.

The corruption within the trials is easier to understand (and entirely predictable since their cost virtually guarantees the sponsor will want a positive outcome which protects their investment). However, I believe the fact that they are a weighted average that sees each patient through a collectivist lens rather than as an individual is ultimately much more harmful.

The collectivist lens makes it possible to ensure the overall greatest benefit (e.g., by having the therapy with a 30% success rate rather than the 25% success rate be the standard of care), but it fails to do anything for those who do not benefit from it (which often comprises the majority of patients).

Unfortunately, there is rarely one correct therapy for every patient. For instance, although there are certain things that are more likely to be helpful for COVID vaccine injuries (e.g., improving zeta potential or a systemic regenerative therapy), when working with a vaccine injured patient, I frequently need to use a different approach from what I’ve done before to improve their symptoms).

This reality is fundamentally incompatible with a standardized model which provides the “best” treatment algorithm for every patient.

One of the most important challenges with evidence based medicine hence becomes “how do I know if the results of this trials are applicable to the patient in front of me?” Unfortunately, while some leaders in the field recognize this issue, the majority of physicians in practice do not seriously consider it.

An excellent example is how to dose pharmaceuticals. Many of my colleagues who get the best results with drugs typically use nonstandard doses (normally lower ones) they calibrate to each patient. Because they do this, they are able to get many of the benefits of the drug without much of the side effects.

However, the majority of doctors use the standard dose pharmacies provide the medication in (reflexively assuming it must be correct), thereby failing to recognize that the dose is a weighted average rather than specific to what each person needs. Furthermore, in many cases, those doses are chosen for the sake of making profit rather than serving patients.

For example, as detailed in the memoir of a Pfizer sales rep, when viagra came out, the FDA approved three doses of the medication:

• 25mg — For the elderly (the most likely to use the drug) and those with kidney problems.
• 50mg — The normal starting dose.
• 100mg — For people who did not respond to the starting dose.

Since Viagra was a new medication, Pfizer was worried too many early overdoses (something their trials had detected was a real risk from the drug) would spoil the market.

So, to preempt this, Pfizer broke with the standard industry practice of charging more for a higher dose and made the price for a 50mg tablet and 100mg tablet be the same so that their sales representatives, seeking to meet their monthly quota, would not try to push the higher dose to doctors and cause too many overdoses from the 100mg formulation.

However, this “backfired” as patients quickly realized they could buy the 100mg pill and then cut it in half to save money. Pfizer panicked (as they assumed their initial design made the pill uncuttable) and instructed their reps to instead tell physicians the 100mg dose was optimal. Later, after better solutions were found to prevent patients getting two Viagras for the price of one, Pfizer again reverted to promoting the 50mg dose.

Personalized Medicine

The medical system is structured to follow a “standardized model” which on one hand allows the medical system to effectively distribute complex treatments to the entire population (which in many cases is a phenomenal accomplishment — for example, most of us can get a correctly performed brain surgery if it is needed) but on the other hand falls short for those the standardized model doesn’t work for.

Since our medical system is structured to favor the collective, in order to make it be able to improve and reliably have everyone in it perform as expected, certain biases uphold that paradigm. They include:

As the last few years have shown the world, these biases can create a lot of problem. For example, because the system is so large (and hence has a great deal of inertia) it is very difficult to get anything to become standard of care unless a lot of money is spent to make that happen.

This results in expensive and not necessarily effective therapies (e.g., remdesivir) disproportionately become the standard of care rather than effective low-cost ones no one can profit off of — especially once a lot of money is at stake and corruption inevitably enters the equation.

Likewise, while the standard model creates effective treatments for many conditions (so we no longer have to worry about them), it is poorly suited for recognizing when it falls short and when innovative doctors try to address those short-comings, they are attacked by the medical system. In turn throughout my life, I’ve seen:

• Numerous cases where a bad therapy stayed on the market for years if not decades because everyone who criticized it was silenced and gaslighted (e.g., consider what we just saw with the COVID-19 vaccines).
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