The catch with so-called “miracle” drugs

Autoimmune diagnoses are tough. Your immune cells are attacking your healthy cells, making for blistering skin rashes, swollen joints, damaged kidneys, problems with asthma and having difficulty breathing, or problems with your brain, leading to pain, balance problems or weakness. Nasty business for sure.

The “good” news is that now there are drug options to treat the most severe autoimmune diseases. The specialists prescribe the new ‘biologic’ drugs that can sharply reduce the attack of the renegade immune cells. But there is a catch. There is always a catch. The price for these drugs is very high on many levels.

The first catch is how expensive these drugs are. The 2011 prices for drugs used to treat multiple sclerosis, an autoimmune disease damaging the brain and spinal cord, were quite substantial. For just one year of therapy these first line drugs were quite pricey:  Avonex ($39,000), Betaseron ($32,000), Copaxone ($45,000) and Rebif ($34,000). The list of side effects for these drugs includes flu like symptoms, pain, fatigue, depression and more.

Still, people took them because they reduced the risk of an acute relapse by about a third. Unfortunately the research has not shown that they reduce the likelihood of needing a walker, wheelchair or becoming bedridden.

Questionable and costly biological drugs

The next round of drugs that have been developed are ‘biologic’ drugs, and they are more potent at stopping the autoimmune activity. These drugs are used to treat rheumatoid arthritis, psoriasis and inflammatory bowel disease. And, yes, their annual cost is also quite high: Humira ($40,000), Remicade ($25,000), and Enbrel $(33,000). And, once again, the list of potential side effects is long and range from annoyances to life threatening infections.

There is a new round of biologic drugs for multiple sclerosis. Like the others I’ve mentioned here, a year of therapy using Tysabri ($42,000/ year), Gilenya ($60,000/ year) or Tecfidera ($54,000/year) will run you a pretty penny. These drugs are more effective at turning off acute attacks, reducing the frequency of relapses by 60% or more, but still come with a long list of side effects that run the gamut from mild to dangerous.

The truth is that anytime we can turn off the immune cells to entirely stop the attack on self, we interfere with the normal healthy immune functions. With substantial changes to the health of the person, and higher risks of infection, the more completely the immune cells are stopped.

Now that we have effective them, albeit incredibly expensive and often with long lists of potential adverse side effects, physicians are often pushing patients to take these new potent drugs. Unfortunately the physicians fail to address the root cause of why the auto-immune problems developed and completely ignore environmental factors that lead to having a severe disease course as opposed to a relatively mild disease.

Holistic approach shows results

For all of our autoimmune diseases there are 150 distinct genes that increase your risk slightly for acquiring a specific autoimmune problem. But the vast majority of people with any of those genes do not become ill with the autoimmune condition. That’s because there are many factors that come together and form a complex interaction.

Those factors include the specific foods you eat, the toxins to which you are exposed, antibiotic use, which bacteria are living in your bowels, your physical activity levels, stress hormone levels, and the level of family and social support you have.

I know one autoimmune condition particularly well. That is multiple sclerosis. I have progressive MS and experienced seven years of steady decline. For four years I was dependent upon a tilt/recline wheelchair. Being an academic internal medicine physician, I sought treatment with the latest drugs, including tysabri.

But I steadily declined for seven years. Then I created a specific diet and lifestyle program designed specifically for my brain. One year later, I was able to bike 18 miles with my family and could walk easily without a cane. Diet and lifestyle restored my health and vitality.

Now I have changed how I practice medicine and the research that I do.  Now I have a therapeutic lifestyle clinic where I take care of people with complex, chronic health problems, often with multiple autoimmune conditions. My patients are taking 20 or more medications, suffering with chronic pain, fatigue and brain fog despite their potent ‘biologic’ drugs.

But once they get to our clinics we run group classes, teaching them about the environmental factors that worsen their disease and the environmental factors that contribute to health. Time and time again, as our patients adopt the diet and lifestyle changes we advocate – their pain diminishes, the brain fog clears and irritability melts away. People begin socializing again, going for walks with family and playing with children and grandchildren.

These magical recoveries begin by addressing the environmental factors that worsen disease: unrecognized food sensitivities, poor quality diet, inactivity, excess stress, unrecognized lead, mercury or other toxin exposures. And all of this treatment is far less costly than the disease-modifying drugs costing $25,000 to $60,000 a year.

The current paradigm for treating a progressive autoimmune disorder is to push drugs and ignore diet and lifestyle because people won’t change. That paradigm is incredibly costly. Teaching patients how to address diet and lifestyle choices to get at the root cause of why their disease is so difficult needs to become part of the standard of care. I am doing the clinical research testing the impact of diet and lifestyle on multiple sclerosis related fatigue. Our results are very exciting, but it will take years, if not decades for the research to change clinical practice.

In the meantime autoimmune diseases are steadily rising, and more suffering and higher and higher costs are associated with autoimmune disorders. But you don’t have to wait for the standard of care to change. You could begin using diet and lifestyle to improve your health, your vitality and begin reducing the severity of your illness. There are so many things that are under your control, that are relatively inexpensive to implement to begin lowering the inflammation, and lowering the pain and fatigue.

For more information visit www.terrywahls.com.