Jim's Story

In 1992, doctors at a VA Medical Center discovered my liver enzyme levels had flared up dramatically.  A test for antibodies suggested a possible autoimmune condition. They began treatment with powerful cortico steroids. My muscles cramped violently. For days, I slept for two or three hours. However, the liver enzyme levels returned to normal. So I was diagnosed with autoimmune hepatitis.  

I asked what might be the long term consequences of taking these powerful steroids? The treating physicians informed me that the dosages I would be taking were so low, 150 mgs, that there were no significant side effects for me to be concerned with. They also advised that I might take these cortico-steroids for the rest of my life.

However, after a few years, I began to notice physical changes. My skin was thinning more and more. A slight brush against an object might cause immediate abrasion and copious bleeding. A few years later I was diagnosed with osteopenia, despite leading an active physical life.  A few years later I was diagnosed with osteoporosis. At each step in the onset of these medical conditions, my treating physicians acknowledged that all of these medical conditions were just normal side effects of a link to a medical study published in the cortico steroids.

 About fifteen years in this treatment regime, I discovered a medical study published in the Lancet, one of England’s leading medical journals. This longitudinal study followed a large group of patients who were treated with the same primary cortico steroid with which I was being treated. After 20 years on azathioprine, it was discovered that 55 percent of the test patients had died of some form of cancer. Just another “side effect.”

On my next visit to my doctors, I pointed out this study to them.  Their response was, “Yes, we are aware of that study. We have to weigh risks.” They were not visibly disturbed or alarmed. Thoughts raced through my mind. What other tissue or organs might be affected by these powerful steroids? But, most disturbing, in three more years I have less than a 50/50 chance of being cancer free, indeed less than a 50/50 chance of being alive.

Three months later I returned for a routine follow up.  My live enzyme levels were normal for the first time in 15 years. Indeed, my liver enzyme levels were now lower than before the onset of the disease in 1992. This is an effect which the powerful and dangerous cortico-steroids never achieved, despite their crippling side effects!

Upon seeing these lab results, one of the doctors asked if I had taken anything that might have contributed to this effect. I stated that I found a doctor (Dr. Joel Fuhrman), carefully and critically read all of his books, read some of his past newsletters, reviewed some of the studies which this doctor had cited in his own publications. I then began following his “autoimmune protocol.”

Basically, I had changed my diet a bit. I offered to give them this doctor’s name and website contact, if they wished to check his work, or the medically published studies upon which he bases his protocol.  The doctors tersely stated that there was no need for such data. They patiently pointed out that I was a perfect example of the placebo effect, and my stabilized liver enzyme levels were only a statistical fluke. They asked me to return in three months for a follow up.

Three months later, the enzyme levels remained low. My treating physicians at the VA, all of them Duke residents, deeply questioned such a dramatic reversal of a fifteen-year history of a chronic disease. They informed me that this does not occur anywhere in their medical literature. They stated I might be experiencing a brief remission, or more likely a transient placebo effect. They advised me to wait and observe for a few more months.

After five more months of careful observation, the liver enzyme levels remained stable and low. I asked if I might be able to reduce the amount of medication, given the notable “side effects.” The doctors pointed out that a rapid withdrawal could initiate a host of medical issues. Just one of these issues is that my adrenal function is also shut down by long term cortico steroid use and my adrenal function might never recover. I asked if I might reduce the dosage very gradually.

After consulting with the supervising physician, the treating physicians gave me guarded permission to begin slowly and cautiously reducing the dosage. I was told, this slow titrating process is necessary and I was also warned firmly that if I had an autoimmune flare up, I would need to go back on these powerful drugs at about double the prior dosage to get this chronic disease back under control.

So I took less medication for three months, my enzyme levels remain low. With their permission, I then titrated down to the next lower dosage for the next three months. This routine continued for another year and a half, gradually, cautiously dropping the prescribed dosage from 150 mgs down to only 10 mgs.  Yet, my liver enzyme levels still remained at their lowest levels in 15 ½ years! I was full of anticipation.

However, my doctors now urged me to not go any further. They pleaded with me to stay on this ultra-low dose regime. They sincerely and kindly explained that I was a perfect example of the cortico steroids still performing their job.  And, they warned unanimously that if I now went off the medication fully, I would put myself at extraordinary risk of a flare up, which would require intervention at substantially higher doses and probably require a cocktail of steroids to regain control.

Needless to say, I took these warnings seriously. These were residents from one of the best teaching schools.  I now faced a critical turning point. All of the choices offered by an esteemed medical school carried high risk. Do I allow these drugs to continue to thin my skin, deplete my bones of calcium density, and potentially trigger some form of deadly cancer? On the other hand, do I want to risk a flare up and be forced to take a much heavier dose of steroids?

Or, do I trust one doctor’s research that suggested this chronic disease might be fully treatable with nutritional excellence alone? Could a simple, but elegant theory of nutritional excellence really save my health and my life? Let me fill in some pieces of the fifteen year back story. Autoimmune hepatitis in men is rare in the United States. Long ago, the doctors asked what might have caused this mysterious disease? The treating doctors at the VA speculate that I may have been set up for this immune condition many years earlier while working in West Africa.

This specific medical condition is common in the region of West Africa where I once served as a U.S. Peace Corps volunteer.  There were probably more microbes per cubic inch evolving and thriving in that rainforest than anywhere else on earth. Bottom line, some variety of fever ultimately seemed to give the missionaries and would be European colonists a very short life expectancy.

My doctors asked if I might have experienced some form of fever while working there. I did remember suffering through one unidentified fever which raged for about three days. At the time, I was located a full day’s journey and several hundred miles from any medical facility. So, as I was trained to do, I “self-medicated.”   I was told to drink all the water you can, before you pass out again.

I remember reading a temperature of 103.3 degrees, just before I passed out. Hours later, I awoke to fever and drenching sweat. I felt I had no energy to even handle a thermometer. So, I quickly reached for the pills, and then the water and then collapsed. For the next several days, I awoke in soaking sweat and still burned with intense fever. Each time, I reached for the pills and water and then lost consciousness. On the fourth morning, I awoke. I was not sweating profusely. I did not burn with fever.
 
So, the VA physicians proposed that my immune system thinks the same virus has returned. More specifically, my immune system thinks that the protein make up in the smooth muscle tissue of my liver is the same, or closely similar, to the protein from that virus from long ago.

 I now pondered this long medical history. I had to weigh the specialists’ best advice at the VA against the research of a pioneering doctor whom, the VA doctors often pointed out, I had only contacted on the web. But  while the medical prescription I’m taking are helping the disease, at the same time these pharmaceuticals are also gradually and inexorably wasting my life from the inside out.  Were the VA doctors and the team of Duke residents correct? Was my success thus far just a placebo effect? Or could a doctor, whose robust research led to a diet of nutrient dense green vegetables, onions, mushrooms, and berries, have a better outcome?

Two other factors now weighed into my critical decision. In the past two years I had the good fortune to personally meet with some of Dr Fuhrman’s other so-called “placebos.”  At the invitation of one of the website members, we all met at his home. We enjoyed a “Dr. Fuhrman dinner and evening.  Here I met people of my age and older, some in their 70's. All of these people were sprite, lively, and glowing with good health. Before going on the Dr. Fuhrman diet, some of these people suffered from severe heart disease.  Some from skin cancers.  Others from a variety of severe autoimmune disease. But alas, none with autoimmune hepatitis. I thought to myself that evening, as patients all we share is our age, our currently good vital signs, and the Dr. Fuhrman diet.

A second factor loomed larger and larger in my mind.  This factor now seemed to outweigh the other considerations. I am speaking of medical ethics. The concept of medical ethics generally begins with some form of an ancient oath, "First do the patient no harm....”
Since my treatment began in 1992, on each visit I brought with me my Excel spreadsheet as well as a chart of my laboratory results. My chart of my liver enzyme levels allowed the resident doctors, who rotate through their residency every few years, to quickly review and understand my entire medical history at a glance.

In fifteen years, just one resident had sufficient medical and scientific intelligence to read a simple, seventeen-year chart correctly, and notice that I was off all medications once, for more than an entire year. The same chart that all of the other residents over fifteen years had seen. This glaring lack of perception gnawed at me.

Year after year, over a cumulative span of fifteen years, I observed that my anomalous data was being tucked out of sight. And, even today not one supervising doctor has ever asked what are you doing now to so dramatically stabilize these enzyme levels? Over the past year and a half, as I titrated lower and lower on the dosage, on a couple occasions, I have the mentioned the name, Dr. Fuhrman to a resident. Or, I have tactfully remarked about published clinical studies cited by Dr. Fuhrman being available. This mild attempt to introduce a new idea to residents, being trained at a top ranked, medical teaching center, draws only blank and speechless resident faces. Intelligent conversation ends right there.

 Dr. Fuhrman’s work has been published along with a vast treasure of meticulously cited and supporting research articles for nineteen years. Just one of his most recent books contains forty five pages of citations of peer reviewed medical studies. Dr. Fuhrman has already performed most of the Herculean work for them.

When the excellent lab results came in, I informed the doctors that I understood their concern about a flare up and I understood and respected their concern. I also stated that I wished to find out whether Dr. Fuhrman’s protocol, which had brought me this far, could now take me completely off any dependency on any pharmaceutical solution. The residents unanimously said, “No. Don’t do that.”

I reminded them again that I first read all of Dr. Fuhrman’s books. I checked out some of the published clinical studies which Dr. Fuhrman cites. There are forty-five pages of cited studies in his first book alone! I was impressed at the consistent quality which spanned many years of Dr Fuhrman’s research.

However, as residents, they needed to bring their recommendation to the supervising doctor. I asked them to bring with them my chart, as I was hopeful this long serving Chief of Hepatology would recognize me by unique chart and spreadsheet, and understand my long standing case. After their consultation they returned and informed me that the supervising doctor, head of Hepatology at Duke, advised, “Let's give this patient the chance to see what is working here.”

I was so happy. I had come across another rare treasure, a wise medical doctor who maintained a delicate balance between caution and medical curiosity. Who maintained a sensitivity to potential new data, and who possessed the moral courage to act boldly but cautiously in the face of new evidence. In the days that followed, I focused on strictly adhering to Dr. Fuhrman's diet more than ever. 110 percent? Heck, no,120 percent.

At the end of six weeks they tested. Totally drug free - all enzyme levels stable. At three months tested again. Drug free - all enzyme levels stable. At six months - drug free and stable.

As of the date of this writing, by following Dr Fuhrman's autoimmune diet, I have been in complete remission for four and one half years! I have been totally free of all medicines and prescriptions for nearly three full years!  I sometimes feel as though I have journeyed for nineteen years through a landscape of competing medical paradigms. 

Imagine if only one medical doctor, among so many, had suggested that I try Dr. Fuhrman’s autoimmune protocol twenty years earlier. What medically induced harm might I have avoided?  Imagine. if twenty years ago, this great teaching University had begun to investigate and design their own studies to further test Dr. Fuhrman’s newly published findings and theory?  Imagine if Dr. Fuhrman’s lonely voice was joined by others in his profession twenty years ago –  generating parallel research at several teaching Universities. These opportunity costs are staggering.

How many fewer incidences of drug induced osteoporosis might have occurred?  How many fewer incidences of drug induced cancer might have occurred?  How many thousands of patients treated with cortico steroids - and now deceased - might have been saved? Indeed, might be alive, vibrant and celebrating a pot luck “Dr. Fuhrman” dinner with other friends and other so-called “placebos?” How much more advanced might our body of knowledge now be of the strategic role that nutritional science, and therefore nutritional excellence, plays in our quality of life? Imagine the colossal wasted medical opportunities. All lost because of a lack of medical ethics, which at some point in the road, will always summon individual moral courage.

This is written with my deep gratitude to the pioneering doctor who decades ago looked at the same medical research available to all of his peers, and who had the singular courage and integrity to follow wherever an evidence based scientific pursuit of truth led. To the pioneering doctor who willingly funded some of this pioneering research out of his own pocket - without the support of his peers and without support from any of the well-funded and great teaching schools of the day.

Post Script, I have also experienced other unanticipated effects since being on this diet. My total cholesterol is now 145, Triglycerides 31.  BMI 18, Blood pressure 93/48 - just where it was as a young athlete in high school and college. Pulse 56. PSA 0.48.
I have not had a cold for the past five winters - am now working on the sixth winter without a cold. How often do you see a man in his mid-60's reverse chronic disease along with improving so many other vital signs?

All of this vital data is readily available to the VA doctors.The fresh crop of residents from the VA - Duke system still adhere to the old paradigm.Recently, they have tested rigorously and exhaustively for signs of other antibodies, for signs of systemic inflammation [IGG], and other potential autoimmune markers.  They have found no sign of any other form of autoimmune disease.

Based on all of their new findings, as well as my long medical history, the current conclusion among this fresh crop of treating doctors remains unchanged. I am a perfect example of the “placebo effect!”  Diet could not possibly correct such a chronic disease.

I still bring my chart to each follow up visit. I am still waiting for the day when a doctor once again looks at the same data and the same chart which all of his colleagues and peers have also seen and says with an open mind, “Wait a minute. You have been stable for several years, without any medication. What is going on here?”

Results may vary.