The Revolution No One's Talking About: Your Data, Your Cure

In this video, we explore the revolutionary shift towards N = 1 medicine—a personalized approach that challenges the traditional one-size-fits-all model in healthcare. Learn how harnessing your individual data can lead to more precise, effective treatments tailored specifically to you. We dive into the limitations of randomized controlled trials (RCTs) and why they may be holding back true medical innovation. Discover the future of medicine, where data-driven insights empower you to take control of your health.

Chapters:
0:00 – Vision of the Future
0:53 – What is a Randomized Controlled Trial
1:27 – Proof of Failure
1:45 – Specificity and Individuality
2:30 – The Future is N = 1 Medicine

[rachelsmith]

Medical biometrics collected on my partner recently indicated excellent HDL/TG ratio, acceptable BP, near "optimal" D-LDL, and placed him in a "very low probability of cardiovascular event" category. Nine days after data collection, he had a heart attack. None of their data collection and mass population studies indicated warning signs for him. N=1 (in retrospect) shows anomalies that should have been addressed. I was already leaning toward N=1 medical choices before this. Now, I'm most certainly focused on N=1 data collection. Currently, I am in an N=1 salt intake study to find the best balance for myself in my journey toward increased health and energy. Thank you for your videos. I appreciate your topics presented and the geeky sciencey parts that roll into your videos so neatly.

[carrikartes]

N of 1.
My husband modestly cut carbs and mega dosed vitamin B1. (and B1 cofactors)
Between 4-6 months he came off his insulin and all diabetic meds.
His A1C was 5.7 when last checked.
Vitamin B1 deficiency is a big factor in insulin resistance. All diabetics are deficient in vitamin B1.
The kidneys waste over 300% more B1 in diabetics than non diabetics.
B1 is vital for mitochondrial health.
80% of the bodies B1 is found within the mitochondria.

[JimWooddell]

Nick, One thing I never thought of when I started my ketogenic journey was I would become an N=1 Scientist. In my journey, along with my wife, we became carnivore and have been near 4 years. Just one thing we have learned, among many many things, is that we are very very different in the way we process the food we eat. With near 4 years of blood glucose and blood ketone data (about every two hours), it is clear she is a far better fat burning machine than I am. If we were clumped into an RCT, not sure this would be shown in such clarity. Our N=1 and N=2 data is just far better. Many current ketogenic influencers tend to talk down doing the intense data collection. Almost all of them. It is just a simple fact. If you don't measure, you don't know. I just finished a fasting N=1 experiment. I confirmed what I thought was right. Can't find that stuff anywhere else that applies to me. Will be posting that data soon.

[melissawitherspoon]

No other person in the world (or the history of the world, for that matter) has ever had the series of choices and events that I have had. To say that one lab result should require a medication, fails to take into consideration all the other aspects of me and my past and current state. Chasing lab results, especially in isolation of everything else, is a terrible approach. I am only now beginning to understand how choices and problems of 30+ years ago have impacted where I am today and how I got here. If medicine had looked at me as a whole, it might have all turned out differently. I hope the N of 1 medicine takes off. I can only see good coming from it! Thanks again, Nick. Another great video!

[Deanriley]

I learned the hard way that I had to be my own health advocate. To document, test, and ask for the treatments I wanted. When I first requested a coronary calcium scan ten years ago, my doctor hadn’t even heard about. Now the practice recommends them. I avoided diabetes and the host of related co-morbidities by paying attention to eating very low carb, exercising, reading about health issues, and believing I didn’t have to age into a pill-popping degraded senior.

[saintwithatie]

This is one of those foundational concepts in scientific epistemology that so many people, even PHD research scientists, fail to understand. There is a trade-off between generality and specific accuracy.

Generally speaking (at the population level) we can calculate the "risks" for outcomes such as ASCVD events or nutritional deficiency, but those calculations can only be applied in turn to the population as a whole. Those statistics do not necessarily hold true in sub-populations, especially the smallest sub-population of the individual.

Additionally, those are statistics, not physical realities. Statistics is not science. For example, LDL being found to be an independent risk factor for ASCVD is a statistical calculation with no relationship to the physical reality. The mere presence alone of LDL does not independently and spontaneously result in plaque buildup. There are a dozen things that have to happen, and each of those things have dozens of factors.

My individual risk of ASCVD based on my LDL levels has nothing to do with the population-level statistics. My individual risk of scurvy based on certain intakes of vitamin C has nothing to do with the nutrient RDAs, which are based on population-level statistics.

Now, I'm not saying that population-level statistics are not useful - they are, especially in making population-level recommendations in the absence of personalized data and a strong understanding of the mechanisms at play. However, far too many people take these statistics as gospel and lose sight of everything else.

These statistics are descriptive, not prescriptive. By body doesn't care about the RDAs - if my body is doing fine on less than the recommended amount of a nutrient, my body is not going to suddenly develop deficiency symptoms because some organization said it should.

If I have an understanding of the mechanisms surrounding the absorption and usage of vitamin C and an understanding of why the statistics are as they are for diferent populations, then I can make sound decisions regarding my vitamin C intake even if those decisions differ from what is generally recommended.

When I tell certain people this, they tell me it's keto or carnivore "cope" and that I don't understand science, when in fact I understand science far better then they do because I, unlike them, understand that statistics is not science. I'm not a "science denier" - the label so many people like to throw around. It's absolutely maddening.

Yes, Nick. I am very salty about this lol

[techadsr]

N=1 is one factor. The walls of silo'd medicine also need to be taken down. Cardiologist can no longer just look at LDL-C and follow the standard of care. They need to look for your root cause and address that cause whether it's diet, environmental, genetic, epigenetic, etc.

[docgl]

Hi Nick. Yes, something has to change. Root cause needs to be investigated more for the individual instead of distributing drugs like there is no tomorrow. Keep pushing for these changes in health care Nick. n=1

[arnoldfrackenmeyer]

I did a N=1 ten year vitamin D personal trial. It paid off BIG time. At least for me and that's what counts.

[softballbryan]

Excellent precise video. Thanks for making and sharing it. I believe this is modern medicine in the future - Customized to each individual.

[gershhayes]

Excellent, i really look forward to the day when the patient is able to participate in a meaningful way in there own healing/health. Thank you

[pascalsimonskoufos]

I was always wondering this...as me an autistic individual or my gf with ADHD and autism and BIPOC, I was always looking at studies with a grain of salt as the individual factor is largely dismissed from the medical/scientific community by it is just an anecdote / N=1. One of your best posts imo and we have to go there I believe. Thanks for all of your hard work!

[RC-qfmp]

What we really need is some kind of third-party vetting of N=1 experiments so that they aren’t dismissed as ‘anecdotes’. Combined it all together into a giant database, let AI do its thing, and we’ll get all kinds of insights when sick people ask the AI what they can do about their problems, and a hierarchy of experimental treatments they can then explore, along with risk-rewards of each, and the exact source of each supporting data.

[andrewrivera]

Yup, I do my own testing except for tests that need a doctor referral and this maybe something everyone needs to talk about, getting any tests you want without a doctors referral. I can’t even get a fasting insulin test without a referral!

[Ed--boiv]

I’m a beta-exile (others call me a type 1 diabetic, but “diabetic” generally means “type 2”, and I find the presuppositions uncomfortable), and I’ve been joking with my docs for over a decade that I’m constantly doing unrandomized uncontrolled trials with a N of 1 on myself. Given my great improvements, they’ve been mostly quite supportive. I no longer have all the data recorded, since I didn’t think anyone would care. I’m hopeful that the approach you outline will take off.

[davidgifford]

I’ve been an n=1 advocate for several years, that implies testing which itself implies being proactive in multiple ways. however there is still a need to read peer reviewed studies including the randomised controls as a place to start, by that I mean reading the data and how it was compiled as the conclusions don’t always match the data sets!

[ilariabertini]

I think this is THE way to help people thrive... we have lots of protocols, lots of guidelines, but people are sicker and more confused. the N=1 IS THE NEW ERA OF HEALTH and we must let people access to self monitoring and data collecting easily. thank you so much NICK

[littleminx]

This is my complaint about randomised controlled trials/studies from two decades ago - articulated. Thank you so much.

[geoffreylevens]

As someone who most often falls on the tail of any Bell curve, I approve of this message. 🤣

[natto]

It’s so frustrating right now because obviously insurance only covers mainstream approaches, then when I do stuff like pay for my full genome out of pocket, I still can’t do much with the information because doctors aren’t trained in genetics even if I research and tell them exactly what it means. I had an antibody test done conventionally which was very suggestive of lupus, which fits my remaining symptoms after years of addressing/fixing everything else, but they just decided to not pursue it and do literally nothing no matter how nonfunctional I am when these spells hit. My full genome also suggests lupus via an antibody variant that typically leads to lupus. No one cares. If you go to the doctor they just want you to shut up. It’s just as well because what doctors can do for lupus is rarely helpful anyway.

I wish I were as optimistic that things will be significantly different in 25 years but I just don’t observe the practice of medicine actually changing in response to new information and technologies. I was doing keto in the 90s and there’s still the same stupid discourse around it today. Med school curriculum is sclerotic because people who paid hundreds of thousands of dollars for their education go on to be the ones deciding what facts are true, and they don’t want to admit lots of the stuff they learned was wrong or harmful and they had no idea what they were doing with tons of their patients. They dedicate their careers to wrong ideas and form rigid little cliques that oversee what all the doctors learn.

I would like to believe that other approaches having better results would shake things up, but I have yet to observe that either. When people do something different and get good results it doesn’t even fully register with them, they’re just glad they don’t have to deal with the patient anymore, and turn around and take another thousand patients they give the same bad advice, because that’s what insurance will pay for.