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"Each of us has unique needs, and the program must meet those needs, not those of someone else,
simply because they received the same superficial diagnosis"

by Dr. Paul A. Goldberg

Each of us is Unique

We all differ in countless ways as acknowledged by Hippocrates who said, “Different sorts of people have different types of maladies.” Conventional medicine and most “alternative practices” base their care on the name given to a person's symptoms rather than to the person having those symptoms. By focusing on symptoms rather than employing care based on causal factors chronically ill people are doomed to lifetimes of suffering.

Primary Causes of Chronic Disease

At conception we receive a genetic heritage from our parents known as our genome. How we express this outwardly is our phenotype, which is modified through environmental factors and our behaviors.

Our genome is found in the chromosomes of each of our trillions of cells. It is estimated that there are 100,000 genes on our 23 pairs of chromosomes making each of us highly unique. As the science of genetics developed it brought about a revolution in understanding as new genes and how they express themselves were discovered. Little practical application of this understanding, however, has filtered into conventional or alternative medicine.

Each one of us is extraordinarily unique

Our genetic variability is astounding. One egg cell has eight million possibilities in terms of its genetic potential, as does each sperm cell, therefore, any two parents produce a combined zygote with any of 64 trillion (eight million times eight million) diploid combinations. It is no wonder that even brothers and sisters can be so different. Looking beyond a single family, each different set of parents generates another 64 trillion possibilities. Each one of us is extraordinarily unique.

In order therefore to help patients reverse a chronic disease it is critical to understand their own makeup. The “disease name” is a title for a manifestation of symptoms and does not represent the complex factors involved in the patient having those symptoms.

Our appearances differ greatly… some are small, some tall, some fat, some thin. There are color variations of black, brown, white, red, and yellow, different facial features, etc. The outward appearances, however, are but a glimpse of the internal variations. Likewise, the differences between chronically ill patients even those with the same medical” diagnosis” are enormous.

In the 1960's, Dr. Roger J. Williams, professor of nutritional biochemistry at the University of Texas described “biochemical individuality”:

“From a practical standpoint we cannot neglect the facts of biochemical individuality. Of necessity, for reasons involving inheritance, every individual has nutritional needs, which differ quantitatively, with respect to each separate nutrient, from his neighbors. The list of nutrients in the nutritional chain of life is presumably the same for every individual. If we were to indicate the quantities of each nutrient needed daily, however, these amounts would be distinctively different for each of us. Some individuals, in the case of specific nutrients, may need from two to ten times as much as others. Each individual has a pattern of needs all his own.”

Biochemical Individuality - Nutritional/Metabolic Needs

One major area of variance between individuals is seen in our nutrient requirements and our ability to excrete waste products i.e. our detoxification potential. Dr. Williams observed significant differences among supposedly uniform animals in their nutrient requirements and their abilities to excrete wastes. Some inbred rats on identical diets excreted eleven times as much urinary phosphate as others Some inbred baby chicks required seven times as much alcohol to bring about intoxication as others;) Research into mercury toxicity has revealed sensitivities that vary as much as a million fold from one individual to another.

Nutrient requirements also vary widely. Even among healthy human subjects a 200-fold difference has been observed in relation just to calcium requirements alone.

We have vastly different nutrient requirements, different digestive and absorptive capacities, different hormonal outputs, different immune systems, different abilities to detoxify toxic materials, etc.

Consider your circumstances. Has your doctor simply named your symptoms and given you treatments or has he/she uncovered the foundational reasons for your illness? Is your doctor addressing the causes of your problems so your health might be restored or are you simply in a lockdown situation where new drugs and treatments are applied for each new symptom as it arises? Can your doctor tell you what makes you different from other cases with similar symptoms?

Even among twins, triplets, and quadruplets at birth, vast biological differences are noted. The adrenaline content of the adrenal glands varied within one set of quadruplet mammals by thirty-two fold. The repercussions of these many differences between patients in practice are enormous yet these differences are rarely considered let alone addressed.

For a physician to determine your care based on a “diagnosis” and not thoroughly investigate you as an individual puts the chances of recovering your health at great peril.

True for the Goose Not always True for the Gander

Many patients come to our clinic because of someone they knew with the same medical diagnosis who recovered their health under our care and they want us to do the same for them. They are often surprised after our investigation that the program laid out for them is very different than that given to the person they knew with the same diagnosis. Each of us has unique needs and the program must meet those needs, not those of someone else, simply because they received the same superficial diagnosis.

Genetics Does Not Doom Us

Our genetics sets the stage for our health potential but does not doom us to illness. Genes involved in chronic diseases generally have to be triggered. Likewise there are steps that can be taken to positively alter a patient's genetic expression so as to return that person to health. This is a challenge we meet head on in daily practice.

Diet is one factor in the expression of our genetics. What we eat in a single meal has minimal impact but long-term dietary choices and the efficiency of our digestive capacity significantly impacts genetic expression. Nutrition does not alter genes but can alter the way genes are expressed.

What is My Preferred Approach?

I am commonly asked by patients or students; “Dr. Goldberg, what would you do for a patient with Rheumatoid Arthritis or Multiple Sclerosis or Crohn's disease or chronic fatigue or diabetes” or (you name the disease).
My response is simple:

I would perform:

  1. A comprehensive case history
  2. A thorough physical examination
  3. Appropriate laboratory studies based on the case history and physical examination.
  4. Each done with the purpose of uncovering underlying causes.

What if it was heart disease, they ask. Again I respond,

  1. A comprehensive case history
  2. A thorough physical examination
  3. Appropriate laboratory studies based on the case history and physical examination.
  4. Each done with the purpose of uncovering underlying causes

But Dr. Goldberg they ask a bit frustrated, what if it was cancer? Again I reply:

  1. A comprehensive case history
  2. A thorough physical examination
  3. Appropriate laboratory based on the case history and physical examination.
  4. Each done with the purpose of uncovering underlying causes

We simply cannot ascertain what to do for the patient by the name of their symptoms alone! How foolish to write books claiming that one has the ultimate answer for any one specific medical diagnostic category when each of us is so different from the next!

The medical diagnostic model has limited utility. When we read about a medical disease and what its outcome is, we are informed what the natural history of the syndrome is under medical care, with the average patient. This is based on the observations of patients who have presented over the years with similar signs and symptoms and received similar treatments and reflects how patients with these signs and symptoms generally respond to medical care.

Reason warrants that we not accept these often-dismal natural histories as being the only possible outcome, but rather the outcomes under medical care and conventional living habits. The many medical disease diagnoses with dismal prognoses are evidence of modern medicine's failures. This need not be the case when the causes of ill health are identified and addressed.

Drawbacks of Diagnostic Categorizations Revealed Through
Case Studies

The following case studies using patients diagnosed with rheumatoid diseases, exemplify the limitations of medical diagnosis.

Two Cases of Psoriatic Arthritis: Pat and Dianne


Pat, a twenty five year old male with psoriatic arthritis was referred to our office. Pat had undergone extensive medical drug therapy without improvement. A thorough case history was taken, a physical examination performed and functional laboratory tests ordered. He was covered with psoriatic scales over 75% of his body including the scalp, face, arms, legs, and trunk. Radiographs of his neck showed significant degenerative changes. Most distressing to Pat were his severe arthritic pains. The history and interview revealed that Pat used alcohol to excess, kept late hours, and had a diet that included many foods lab testing would reveal he was sensitive to. There was no family history of autoimmune disease.

After reviewing the results with Pat, it was determined he should undergo a supervised fast which lasted seven days. The patient rested, slept long hours, and took sunbaths. Initially the skin lesions increased but by the sixth day had begun to fade. At the end of seven days the fast was broken. The psoriatic lesions were more than 70% gone. This was followed by an appropriate diet plan along with extensive guidance regarding hygienic aspects of living specific for his circumstances.

The joint pains subsided over the next several weeks and the patient returned home largely cleared of psoriatic lesions and with vastly improved joint comfort. He was given a program based on his individual traits to allow him to continue to progress without ongoing reliance on physicians. Causes identified, causes addressed, health restored.


Two months after seeing Pat we received a call from Dianne, a lady who had also been diagnosed with psoriatic arthritis. She knew Pat through an arthritis support group they both attended. Dianne related that she was impressed with Pat's vast improvements with a condition deemed “incurable” from which she had suffered with herself for many years.

She had questioned Pat as to what he did under my care. What foods he was told to eat, which to avoid, what supplements had been given, how long he fasted, etc. Dianne then followed the same plan with disappointing results. The unsupervised fast she took was disastrous leaving her weak and debilitated. The foods she ate gave her indigestion, and she found her joint pains, skin and general health worse off than before she had started.

I explained to Dianne that she was a different person and what had worked for Pat was based on his makeup, his history, his biochemistry, not hers. She emphatically replied that her case was the same since they both had been diagnosed with “psoriatic arthritis.”

Many doctors and patients believe if two people have the same medical diagnosis that they have the same problem and therefore what will benefit one will benefit another. This is a perilous error. I explained to Dianne that a program of care for her would need to be based on her specific traits, not on a medical title she had been tagged with.

Soon after Dianne traveled to our clinic for care. I found her debilitated by her attempts at fasting, which were inappropriate in her case. She suffered from exhaustion, very weak digestion and low body temperature. She had followed a raw food diet along with drinkingfruit juices because she had read in a book on psoriasis that raw foods were “good for psoriasis” and that juices would “cleanse” the tissues. Dianne erroneously based her care on the name of her disease rather than understanding her own constitution.

We helped Dianne recover by developing a program based on her biochemical individuality, which turned out to be very different than Pat's. The roots of her problems leading to her psoriatic arthritis symptoms revolved around poor fat digestion which had been the case with her Mother, low thyroid and adrenal function, a troubled marriage, and a protozoa infestation that she had likely picked up traveling in Central America. Despite the same medical diagnosis the roots of her health problems were different from Pat's.

Patients with the same medical diagnosis have different reasons why they become ill. I am not indifferent to serious diagnoses e.g. lupus, psoriatic arthritis, rheumatoid arthritis, ulcerative colitis, etc., but since such titles represent only superficial information they do not cause me to panic either.

Three Cases of Rheumatoid Arthritis

Each of the following cases of medically diagnosed Rheumatoid Arthritis received similar medical treatments based upon the diagnosis and each was continuing to worsen when we first saw them. The causal factors behind their conditions differed and therefore the protocols we employed in helping each recover had distinct differences as well.


Mary, a 55-year-old female had been diagnosed with rheumatoid arthritis three years previously after a stressful period in her life when she had lived mostly on pasta, pizza, bread and potatoes. Her hands were painful and she had poor grip strength. Multiple joints were inflamed and her sedimentation rate was over 100 (normal = 0 to 20). She was dismayed by the failure of the drugs prescribed to her (steroids followed by Embrel and later Remicaide) and equally discouraged by the failures of the many bottles of “natural remedies” she had tried that were supposedly “good for arthritis”. The drugs initially suppressed some of her symptoms but later she developed a serious lung infection due to the suppression of her immunity. Mary was also taking an assortment of herbs, homeopathic agents and “Flower Remedies” given to her by a Naturopath.

Mary's rheumatoid disease emanated from her gastrointestinal tract as revealed by the history, exam and functional laboratory testing. I required her to eliminate starches as (in her case) they were promoting specific bacterial growth contributing to her inflammation. The cause was straightforward.

Mary was cooperative. In four months improvements in both her blood chemistries and a reduction in the patient's pain and swelling were obvious. Today she is fully mobile, off all medications and enjoys good health. The causes were identified and addressed and led to a restoration of health.


Joan, a 42-year-old female from the mid-west arrived at our clinic with medically diagnosed rheumatoid arthritis. She could walk only slowly with considerable pain. The hands, knees, wrists, hands, and feet were markedly inflamed. She was receiving methotrexate and humera, all immune suppressant drugs. Her Aunt and a first cousin also had autoimmune disorders.

Joan had taken good general care of herself. She had, however, recently undergone an unexpected divorce from her husband of over twenty years whom she had put through school working long hours to do so. Putting salt on the wound the divorce was followed within three weeks by her husband marrying his young secretary.

Her blood work showed her to be anemic, have low serum protein levels and an elevated sedimentation rate and high C-reactive protein level. She had been a hard worker and had significantly shorted herself on sleep over the years. She had elevated levels of mercury in her tissues due to dental amalgams, an elevated indican level (a toxin resulting from bacterial breakdown of protein) in her gut, yeast overgrowth and imbalances in her trace mineral levels. An individual program of care was developed based on these factors.

Initially she made rapid progress. The sedimentation rate dropped rapidly within a few weeks and the patient felt much improved. She was required to obtain long hours of sleep, stay on a liquid diet for intervals ranging from three days to a week, take oral chelating agents and specific trace elements, undergo trigger point therapy in our office and take steps to address both the overgrowth of yeast and the high level of indican in her intestines. She returned home for several weeks to take care of business matters prior to returning to our office for further care. When she returned I found she had lost ground on the progress we had made and the inflammatory markers had risen again.

A lengthy discussion with Joan revealed that while home she had seen her former husband and his new wife in a convertible purchased shortly before the divorce. She experienced a surge of anger that was continuing to rage. I recommended counseling which she obtained, to address this issue. Within the next several months with counseling and continued attention to the areas previously mentioned, the patient improved again as her emotions settled. Her inflammatory index dropped and she returned home without carrying the emotional burden and with her biochemical issues addressed.


Mark, a twenty seven year old male, presented at our clinic with medically diagnosed rheumatoid arthritis. He had been seeing a rheumatologist for six months and was continuing to worsen. There was no significant family history. He had formerly been active with weight lifting, running, and motorcycling but now was stiff and weak with swollen joints. His rheumatologist told him that “rheumatoid arthritis” was “incurable” and that he would have to adapt to the reality that he would become crippled with time. Drugs including methotrexate and steroids had left him weak and nauseated. Switching to Enbrel had brought only partial relief of symptoms and left him frightened regarding the serious side effects he knew could occur including lymphoma and tuberculosis. An “alternative” medical physician had placed Mark on a number of glandular substances and advised him to take colonics, which he had reluctantly done.

Following a lengthy interview, lifestyle analysis and functional laboratory testing Mark was given a report of findings. A significant finding was his impaired glucose tolerance, which we traced to his heavy use of soft drinks. This had weakened his glucose regulating ability contributing to a pro-inflammatory state, further compounded by a significant imbalance in his fatty acids.

After restoring his glucose balance through dietary and improving his fatty acid profile both primarily through dietary intervention the patient recovered from his “rheumatoid arthritis” discomforts in less than eight weeks. Years later the patient continues to be well and engages in heavy physical activities without difficulty. All signs of the “rheumatoid arthritis” disappeared when specific factors addressing his biochemical traits were addressed.

All three of these patients, Mary, Joan and Mark, presented with an identical medical diagnosis of rheumatoid arthritis. Their symptoms were similar yet the causal factors behind their illnesses were vastly different. Different biochemical factors and emotional backgrounds were at play. The times required for recovery and the strategies used in effecting a reversal of their condition also differed. The reasons behind their illness had been ignored by the Medical Rheumatologists each of whom simply applied toxic, symptom suppressive drugs and by “alternative practitioners” who had applied safer, yet ineffective measures that likewise ignored causal factors.

A Look At Mans Best Friend

A convincing way to appreciate our individuality is to consider different breeds of dogs, from the Chihuahua to the Great Dane.

All domestic dogs belong to a single species, Canis familiaris. The many breeds are descended from a small subspecies of wolf, Canis lupus pallipes.1 Selective breeding has produced a wide variation of different canine appearances, strengths, weaknesses and personalities. It is difficult to imagine, when one looks at different breeds that all share a common ancestry. All the breeds are dogs yet their health problems differ widely based on unique traits related to their breed and as an individual within that breed.

The dachshund is subject to inter-vertebral disc disease and diabetes, the Rhodesian Ridgeback to dermoid sinuses (cysts), the Scottish Deerhound to gastric torsion, the Chihuahua to incomplete closure of its skull, the Toy Poodle to early tooth loss, the Bulldog to heat stroke, the German Shepherd to hip dysplasia, etc. Life spans differ also. The Schipperke from Belgium commonly lives to 20 years of age, while the Irish Wolfhound averages only about five to six years. As with humans, environmental factors e.g. diet, exercise, etc., greatly affect the propensity of each breed to develop the genetic weaknesses it is subject to as well as determining how long the lifespan will be, within the boundaries of its genetic heritage.

Working With The Hand of Cards We Were Dealt

To understand each patient's uniqueness is to be able to maximize their health potential to a degree many thought not possible. Our patients have recovered from numerous so called “incurable” chronic conditions by understanding their makeup, the reasons they became ill and addressing the causal factors in each case while simultaneously creating the conditions for health to flourish. Part of the challenge is to help patients understand they need not accept the dismal outlook painted for them by so many doctors nor accept symptomatic treatments whether from standard or “alternative” doctors as their only solution.

I was born somewhat a runt and I had to learn to live within certain runt limitations. Yet as I round the corner on sixty I look back with satisfaction at what I have been able to achieve, at being able to reverse a chronic disease condition and enjoy my life as an adult. A Chihuahua cannot become a Great Dane…but the Chihuahua that I was born as, with right knowledge and effort overcame chronic disease and become like a Jack Russell Terrier. I am enormously thankful for having learned from doctors who were pioneers in Natural Hygiene, Clinical Nutrition and Clinical Epidemiology as well as from my own trials and errors how to understand my unique attributes and achieve my potential as one of six billion unique individuals on planet earth.

I have read the hand of cards nature dealt me and learned how to play them in a productive manner. I have also been blessed in having the opportunity to assist many patients who were once chronically ill do the same.

Paul A. Goldberg, MPH,DC,DACBN

Also read: Common Errors in Natural Hygiene


"One major area of variance between individuals is seen in our nutrient requirements and our ability to excrete waste products i.e. our detoxification potential."

Natural Health & Energy
INHS Hygienic Review

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