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gorskon's profile
David Gorski, MD, PhD
David Gorski, MD, PhD
David Gorski, MD, PhD
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@gorskon

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David Gorski, MD, PhDVerified account

@gorskon

Surgeon/scientist promoting science in medicine and exposing quackery. Editor of Science-Based Medicine. My opinions do NOT represent those of my employers.

Michigan, USA
sciencebasedmedicine.org
Joined October 2009

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    1. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      Functional medicine posits that we are so different as individuals that each of us needs a completely individualized treatment plan because each individual is unique and quite different from all the others. 3/

      1 reply 0 retweets 1 like
      Show this thread
    2. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      To follow that end, functional medicine strives for a Theranos-like vision. FM docs measure the levels of literally dozens, if not hundreds, of hormones, minerals, metabolites, micronutrients, proteins, cytokines, etc. in the blood. 4/

      1 reply 0 retweets 1 like
      Show this thread
    3. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      Functional medicine docs also abuse systems biology, doing genomic testing whose results we don't yet know how to interpret or act on. They also invoke the microbiome, metabalome,etc., again making it up as they go along. 5/

      1 reply 0 retweets 2 likes
      Show this thread
    4. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      Any clinical pathologist knows that when you do so many simultaneous tests, by random chance alone about 5% will be abnormal, because the normal range for lab tests is often defined as within two standard deviations of the mean. So there will be a lot of false positives. 6/

      1 reply 0 retweets 6 likes
      Show this thread
    5. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      Functional medicine will seek to treat all the "abnormal" lab values found, whether they need treating or not, whether they have any known, validated relevance to human health and disease or not, this violating the medical adage, "treat the patient, not the labs." 7/

      1 reply 0 retweets 1 like
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    6. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      But to functional medicine, we're all "biochemically individual." So we get hyper-"individualized" testing and treatment, whether it makes a difference or not. 8/

      2 replies 0 retweets 0 likes
      Show this thread
    7. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      Here's an example of what I mean in the form of a functional medicine "case report." It's of an 80 yr. old woman with locally advanced breast cancer. Notice the sheer number of tests ordered and the supplements given, including high Dose vitamin C. 9/https://sciencebasedmedicine.org/functional-medicine-the-ultimate-misnomer-in-the-world-of-integrative-medicine/ …

      1 reply 0 retweets 1 like
      Show this thread
    8. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      If you look critically at what the functional medicine quacks did here, the only things that likely helped this woman were the exercise, the part time care giver, and the counseling and group support. No supplements or dozens of lab tests needed. 10/

      1 reply 0 retweets 0 likes
      Show this thread
    9. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      If you look at functional medicine in practice, it's basically a shotgun approach to medicine. Functional medicine docs make it up as they go along and throw a whole bunch of things at the wall to see what sticks. 11/https://sciencebasedmedicine.org/functional-medicine-in-practice/ …

      1 reply 0 retweets 0 likes
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    10. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      This brings me back to Theranos. The ethic is the same as functional medicine. It's a belief that testing as many things as possible will reveal the "biochemical individuality" of the patient and allow for "individualized treatment." 12/

      1 reply 0 retweets 0 likes
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      David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

      If Theranos could have actually delivered a product, functional medicine docs would have loved it and likely been some of Theranos' most enthusiastic customers. 13/

      8:15 AM - 5 Sep 2018
      1 reply 0 retweets 0 likes
        1. New conversation
        2. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

          Functional medicine docs also share with Silicon Valley techoprophets a touchingly naive faith in technology as a solution to every problem. Functional medicine docs share this faith, for example... 14/https://respectfulinsolence.com/2018/09/05/robin-berzin-functional-medicine-concierge/ …

          1 reply 0 retweets 2 likes
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        3. David Gorski, MD, PhD‏Verified account @gorskon 5 Sep 2018

          I foresee a confluence between Silicon Valley and quacks, and it likely will be functional medicine quackery leading the way. 15/15

          1 reply 1 retweet 2 likes
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        4. End of conversation

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