# Medical system secrets: what doctors won’t tell you

> *"The medical system is reactive, not proactive. You have to be your own advocate."*

> Use this information to inform yourself. The medical system tries to help you, but they are not flawless.

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## The system’s flaws: what’s really happening

### 1. "We’re trained to treat symptoms, not root causes"
**Example:**
You get a statin for high cholesterol, but no discussion about *why* it’s high (insulin resistance? inflammation? stress?).
**Why?** Many doctors lack time (or incentive) to dig deeper.

**What to do:**
- Ask: *"What’s causing this, and how can I reverse it naturally?"*
- Push for functional medicine or lifestyle changes *before* medication.

---

### 2. "Hospitals are dangerous-avoid them unless absolutely necessary"
- 1 in 25 patients gets a hospital-acquired infection (CDC).
- Medical errors are the 3rd leading cause of death in the U.S. (after heart disease and cancer).

**What to do:**
If admitted:
- Insist on hand hygiene (watch staff wash hands before touching you).
- Bring an advocate (friend/family) to ask questions and take notes.
- Question every medication: *"What’s this for, and what are the side effects?"*

---

### 3. "Many ‘normal’ lab ranges are too lenient"
**Examples:**
| Test               | "Normal" range       | Optimal range          | Risk if "normal" but suboptimal |
|--------------------|----------------------|------------------------|----------------------------------|
| TSH (thyroid)      | 0.5-5.0              | 1.0-2.0                | Hypothyroid symptoms            |
| Vitamin D          | 30-100 ng/mL         | 50-80 ng/mL            | Weak immunity, higher cancer risk |
| Fasting glucose    | <100 mg/dL           | <85 mg/dL              | Diabetes risk                   |

**What to do:**
- Ask for actual numbers-not just "normal/abnormal."
- Research optimal ranges (e.g., [Functional Medicine standards](https://www.ifm.org/)).

---

### 4. "We overprescribe antibiotics-and it’s killing people"
- 30% of antibiotic prescriptions are unnecessary (CDC).
- Consequences: superbugs (MRSA), gut destruction, weakened immunity.

**What to do:**
- Ask: *"Is this absolutely necessary, or can we wait/watch?"*
- If prescribed, take probiotics (S. boulardii) 2 hours apart from the antibiotic.

---

### 5. "Surgery is often overused-get a second opinion"
**Examples of overused surgeries:**
- Knee arthroscopy (meniscus tears): no better than placebo ([NEJM study](https://www.nejm.org/)).
- Hysterectomies: unnecessary in ~50% of cases (ACOG).
- Back surgery: fails 40% of the time (*Spine Journal*).

**What to do:**
- Always get a second opinion before elective surgery.
- Ask: *"What happens if I do nothing?"*

---

### 6. "We don’t know as much as we pretend"
- Medicine is part science, part guesswork.
- Many treatments rely on outdated studies or pharma influence.

**Example:**
- SSRIs work for ~30% of people, but doctors rarely mention lifestyle fixes first (exercise, omega-3s, therapy).

**What to do:**
- Ask:
  - *"What’s the evidence behind this treatment?"*
  - *"Are there safer alternatives?"*

---

## What doctors won’t tell you about medications

### 1. "Pharma reps influence what we prescribe"
- Doctors get free meals, trips, and "educational" perks from drug companies.
- Studies show this changes prescribing habits (*JAMA*).

**What to do:**
- Ask:
  - *"Is there a generic or cheaper alternative?"*
  - *"Are you familiar with non-drug options?"*

---

### 2. "Some drugs cause the problem they’re supposed to fix"
| Drug class          | Example drugs       | Hidden risks                          |
|---------------------|---------------------|---------------------------------------|
| PPIs                | Omeprazole          | Dementia, bone fractures, gut infections |
| Statins             | Atorvastatin        | Diabetes, muscle damage               |
| Sleeping pills      | Ambien              | Dementia, falls                       |

**What to do:**
- Always ask: *"What are the long-term side effects and withdrawal risks?"*
- Research deprescribing (how to safely stop).

---

### 3. "Psychiatric drugs are overprescribed-and hard to quit"
- 1 in 6 Americans takes a psychiatric drug (antidepressants, ADHD meds, etc.).
- Withdrawal can be brutal (brain zaps, depression, insomnia)-but doctors often don’t warn patients.

**What to do:**
- Never stop cold turkey.
- Work with a doctor on a slow taper (resources: [The Withdrawal Project](https://www.thewithdrawalproject.com/)).

---

### 4. "Painkillers (even OTC) are more dangerous than you think"
| Drug               | Risk                                  |
|--------------------|---------------------------------------|
| NSAIDs (ibuprofen, naproxen) | 30%+ higher heart attack risk (FDA) |
| Acetaminophen (Tylenol) | #1 cause of acute liver failure     |

**What to do:**
- Try natural alternatives first:
  - Turmeric, boswellia, or CBD for inflammation.
- If using NSAIDs:
  - Take with food.
  - Limit to 3-5 days max.

---

## Tests & screenings they skip (but you should demand)

### 1. "We don’t test for critical deficiencies unless you ask"
| Deficiency         | Symptoms               | Why it’s missed               |
|--------------------|------------------------|-------------------------------|
| Vitamin B12        | Neuropathy, depression | Not routinely tested (20% deficient) |
| Ferritin           | Fatigue, hair loss     | Doctors test hemoglobin, not iron stores |
| Homocysteine       | Doubles Alzheimer’s risk | Rarely checked               |

**What to do:**
- Request these tests if you have symptoms (fatigue, brain fog, tingling).

---

### 2. "Your thyroid test is probably incomplete"
Most doctors **only test TSH**, but you need:
- Free T3 (active thyroid hormone)
- Free T4
- Reverse T3 (if stressed)
- Thyroid antibodies (Hashimoto’s)

**What to do:**
- Insist on a full thyroid panel if you have fatigue, weight gain, or hair loss.

---

### 3. "We rarely check for autoimmune diseases-even when symptoms scream it"
- 90% of autoimmune diseases (Hashimoto’s, lupus, RA) go undiagnosed for years.

**What to do:**
- If you have chronic fatigue, joint pain, or mysterious symptoms, demand:
  - ANA (antinuclear antibodies)
  - CRP (inflammation marker)
  - Specific antibody tests

---

### 4. "Your ‘normal’ blood pressure might be too high"
- Old "normal": 140/90
- New guidelines (2017): 120/80 = "elevated"
- Optimal for longevity: 110-115/70-75

**What to do:**
- Monitor at home (white-coat hypertension is real).
- Fix with: magnesium, beetroot juice, walking.

---

### 5. "We don’t tell you about cheap, effective cancer screenings"
| Screening          | Who needs it          | Why it’s skipped              |
|--------------------|-----------------------|-------------------------------|
| LDCT (lung)        | Smokers/ex-smokers    | Reduces death by 20%          |
| FIT test           | Colon cancer screening | More accurate than colonoscopy in some cases (but less profitable) |

---

## What doctors should tell you about aging

### 1. "Muscle loss starts at 30-and it’s deadly"
- Sarcopenia (muscle loss) begins at 30, accelerates after 50.
- Low muscle = higher risk of falls, diabetes, early death.

**What to do:**
- Lift weights 2-3x/week (even bodyweight exercises help).
- Eat 30g protein per meal (focus on leucine-rich foods: eggs, whey, chicken).

---

### 2. "Your ‘normal’ cholesterol might be killing you slowly"
- **LDL particle size** matters more than total LDL.
  - Small, dense LDL = heart attack risk (most doctors don’t test for this).
- Triglycerides >100 = insulin resistance (even if "normal").

**What to do:**
- Ask for **NMR or LDL-P test**.
- Fix with: low-carb diet, omega-3s, exercise.

---

### 3. "Alzheimer’s starts in your 40s-but we won’t test for it"
- High blood sugar, obesity, poor sleep in midlife = 2x Alzheimer’s risk.
- ApoE4 gene = 3-4x higher risk (but doctors rarely test).

**What to do:**
- Get a dementia risk panel:
  - Fasting insulin
  - HbA1c
  - Homocysteine
  - CRP
- Test for ApoE4 (via 23andMe or doctor).
- Prevent with: ketogenic diet, exercise, sleep optimization.

---

### 4. "Your bones are weaker than you think-even if you drink milk"
- Osteoporosis is silent until you break a hip (often too late).
- Dairy isn’t enough-you need:
  - Vitamin K2
  - Magnesium
  - Weight-bearing exercise

**What to do:**
- DEXA scan at 50 (earlier if risk factors).
- Jumping/running builds bones better than walking.

---

### 5. "Hearing loss accelerates dementia-but we don’t screen for it"
- Mild hearing loss = 2x dementia risk.
- Severe hearing loss = 5x risk (Johns Hopkins).

**What to do:**
- Get a hearing test at 40.
- Use hearing aids if needed (they slow cognitive decline).

---

## Vaccine & prevention truths

### 1. "Some vaccines are more important than others"
| Vaccine            | Why it’s critical                     |
|--------------------|---------------------------------------|
| Shingrix           | Prevents excruciating nerve pain (1 in 3 gets shingles) |
| HPV (Gardasil)     | Prevents multiple cancers (throat, cervical, anal) but underused in adults |
| Pneumovax          | Saves lives in older adults but often skipped |

**What to do:**
- Ask your doctor about these by name.

---

### 2. "We don’t talk enough about the ‘anti-cancer’ lifestyle"
- 30-50% of cancers are preventable (WHO) with:
  - No smoking
  - Limiting alcohol (even 1 drink/day ↑ breast cancer risk)
  - Avoiding processed meats (bacon, hot dogs → 18% higher colon cancer risk)
  - Vitamin D >50 ng/mL

**What to do:**
- Get a CRP test (inflammation marker).
- Adopt an anti-cancer diet:
  - Cruciferous veggies (broccoli, kale)
  - Turmeric
  - Green tea

---

## Money-saving secrets doctors won’t tell you

### 1. "You can negotiate medical bills-even after paying"
- Hospitals overcharge by 300-1000% and will reduce bills if you ask.

**What to do:**
- Call billing and say:
  > *"I can’t afford this. Can you reduce it to Medicare rates?"* (Often works.)
- Use services like [Medical Billing Advocates of America](https://www.billadvocates.com/) if denied.

---

### 2. "Generic drugs are (almost) always just as good"
- FDA requires generics to be 95-105% as effective as brand-name.
- **Exception:** Thyroid meds (Synthroid vs. levothyroxine)-some do better on brand-name.

---

### 3. "You don’t need most ER visits-urgent care is cheaper"
| Scenario           | ER cost | Urgent care cost |
|--------------------|---------|------------------|
| Sprained ankle     | $2,000+ | $150             |

**What to do:**
- Only go to ER for:
  - Chest pain
  - Stroke symptoms
  - Severe trauma

---

### 4. "We order unnecessary tests because we’re afraid of lawsuits"
**Example:**
- MRIs for back pain (usually show "abnormalities" that are normal with age but lead to unnecessary surgeries).

**What to do:**
- Ask: *"Will this test change my treatment?"* If not, skip it.

---

## The hard truths about death & dying

### 1. "We overtreat at the end of life-and it causes suffering"
- 25% of Medicare spending goes to the last year of life (often on futile treatments).
- Most people don’t want aggressive care-but doctors default to "do everything."

**What to do:**
- Get an advance directive (specify DNR, DNI, comfort care).
- Talk to your family about your wishes now.

---

### 2. "Hospice is underused-and it’s a gift"
- Hospice improves quality of life but is only used in the last 3 weeks (avg.) when 6 months are covered.

**What to do:**
- If a loved one has a terminal illness, ask about hospice early.

---

### 3. "We don’t tell you how to die well"
- Most people want to die at home-but 60% die in hospitals.
- Morphine isn’t just for pain-it eases the "air hunger" of dying (but families often resist).

**What to do:**
- Read *"Being Mortal"* by Atul Gawande.
- Have the hard conversations early.

---

## The most important thing doctors won’t say
> **"You have more power than you think"**

- 80% of chronic disease is preventable (CDC).
- Lifestyle beats genes in most cases (even with family history).

**You can reverse:**
- Type 2 diabetes (low-carb + exercise)
- Early heart disease (diet + stress management)
- Autoimmune flares (gut healing + sleep)
- Early dementia (ketogenic diet + exercise shows promise)

**But you must:**
- Demand the right tests.
- Ask the right questions.
- Take action.

---

## What you can do today

### 1. Get these tests (if you haven’t)
- Full thyroid panel (TSH, Free T3, Free T4, antibodies)
- Vitamin D + B12
- Homocysteine + CRP (inflammation markers)
- HbA1c + fasting insulin (diabetes risk)

### 2. Ask your doctor:
- *"What’s the root cause of my symptoms?"*
- *"Are there lifestyle changes I can try before medication?"*
- *"What are the side effects and alternatives to this drug?"*

### 3. Start these habits:
- Walk 10K steps/day (non-negotiable for longevity).
- Lift weights 2x/week (even bodyweight squats count).
- Sleep in a cold, dark room (65-68°F, blackout curtains).
- Eat 30g protein at breakfast (prevents muscle loss).

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## Final thought
The medical system is reactive, not proactive.
**The best doctors wish patients would:**
- Ask more questions
- Demand root-cause testing
- Take lifestyle seriously (diet, sleep, stress)

**What’s one thing from this list you’ll act on this week?**
*(I’m starting with requesting a full thyroid panel-turns out my "normal" TSH might be hiding Hashimoto’s!)*

Stay curious, stay skeptical, and take control of your health.