Spoiler alert: I’m going to talk about vaccinations.

This subject has become so polarizing that any slight deviation from the establishment line on this—no matter how nuanced or reasonable—gets you lumped in with the antivaxxers, widely derided as crazies, science-denying, conspiracy-theorizing wing nuts.

Believe me, I get the risks associated with speaking out about this. I know you can’t talk about the vaccination issue without pissing off large swatches of the population, not to mention risking the wrath and condemnation of your fellow health-professionals.

I also get that the majority of the people reading this have already made up their minds on the subject of vaccines. Either you think it’s madness not to vaccinate, or you think it’s madness to vaccinate.

Well, relax. I’m actually not writing this column for either group.

I’m writing it for the small sliver of people who might still be somewhere in the middle.

But first, let me introduce…

Before we get into vaccinations and autism—and I promise, we will— let me introduce someone named Dr. Roger Williams.

Roger Williams, MD, was the spiritual father of the whole integrative and functional medicine movement. Everyone in the “health space”—or at least, everyone you’re likely to be reading if you’re reading me— has studied Roger Williams’s landmark book—Biochemical Individuality. That book taught us that everyone is biochemically unique and that despite all our similarities, we should never lose sight of the enormous, measurable differences in all sorts of “out of the box” specifications. (I’ll get to why that matters in a moment.)

Now let’s jump forward to the subject of vaccinations, specifically vaccinations and detoxification.

Vaccinations and Detoxification

Every single time you introduce any foreign substance into the body, that substance will ultimately wind up in the liver. The liver then begins the process of detoxification—essentially rendering the foreign object harmless, and turning toxins into water-soluble waste that can be eliminated through urine, stool, skin and sweat.

The liver accomplishes this through a two-phase process of detoxification involving a group of enzymes called the Cytochrome P450 enzymes, and metabolic processes such as conjugation and glucuronidation. The end result—when all goes well—is that foreign compounds are effectively disposed of. These foreign compounds include (but aren’t limited to) toxins in the air, recreational drugs, pesticides, birth control pills, alcohol, prescription medicines… and, yes, vaccines.

While Dr. Williams didn’t specifically study the Cytochrome P450 enzyme system, let’s look at what he did study and see if it might be able to shed some light on detoxification and vaccinations. I think it can.

Dr. Roger Williams and Biochemical Individuality

Williams showed illustrations of 19 different laboratory specimen human stomachs and 17 different human livers, each of dramatically different shape and size. He showed that the thyroid gland in normal people varies from a weight of 8 grams to 50 grams. He demonstrated that pepsin, an important digestive enzyme produced by the stomach, varies in the normal stomach by a thousand-fold.

He reported dramatic differences among normal healthy infants in leukocytes, neutrophils, eosinophils, basophils, lymphocytes and monocytes, all specific types of blood cells.

He reported on huge differences in the musculature of the pectoralis minor muscle, and on variations in the amount of islet tissue in the pancreas. He suggested that the potential rate of production for insulin probably varies throughout a ten-fold or greater range, and that the number of insulin-producing cells in the pancreas varies from 200,000 to 2.5 million—all, mind you, in normal people.

So now I’d like to pose a theoretical question.

Is it not possible that there might also be significant differences in the Cytophrome P450 enzyme system? The very same system that detoxifies foreign substances like, for example, vaccines?

Is it completely impossible that different individuals might vary in the strength and effectiveness of their ability to detox effectively, perhaps due to inborn variations in their detoxification pathways?

And could an unusual variation in the ability of one’s Cytochrome 450 enzyme system to function effectively under certain conditions of challenge—like a vaccine–explain why there might be an atypical, extreme response to a foreign compound even though that foreign compound doesn’t seem to cause harm in others?

It’s hard to see how there could not be such individual differences.

After all, if the detoxification system of the Cytochrome P450 enzymes worked exactly the same way at exactly the same efficiency with exactly the same results in every single human on the planet, then it would be the only such system in the human body that did so. (Remember, every other system Williams studied showed enormous individual differences.)

And if you’re still skeptical about how this notion of individual variation could possibly apply to detoxification pathways, consider two people of the same size, age and sex: one drinks a bottle of Jack Daniels and walks a straight line home while reciting the Constitution, the other gets wasted on one beer. That difference in response to alcohol is almost certainly due to individual differences in the amount of an enzyme known as alcohol dehydrogenase, which detoxifies ethanol in the human body.

We’ve all seen with our own eyes huge individual differences in the ability to handle alcohol. Is it so inconceivable that there might be significant differences in the ability to handle a particular vaccination?

Isn’t it at least possible that there are some children— not all mind you, not even a majority, maybe not even a double digit percentage, but some percentage of children nonetheless—whose enzyme system simply cannot handle the challenge of the vaccination as it is currently given?

Averages don’t tell the whole story

Now please understand me here. I am talking about a small sub-set of children. And that’s a critically important point.

See, when researchers do huge, studies looking for a connection between vaccinations and autism in multi-thousand patient populations followed over many years, they consistently find no relationship. And they are not lying. When you look at the data with that kind of helicopter view —which is exactly the way public health officials look at data—the conclusion is irrefutable. Vaccines don’t “cause” autism.

So this is what you need to understand about that research, and about epidemiological research in general.

The data on thousands and thousands of people followed over many years often obscures small sub-group differences.

So a study that examined the medical records of, say 50,000 children who were vaccinated over the course of a decade would indeed find no increase in the incidence of autism.

I completely accept that research—you’d be crazy not to.

But there’s a “but”…

I’m suggesting that there might be a sub-group of children, obscured in the averages, for whom the connection between autism and vaccines is a little more complex.

Here’s an easy way to understand how something that is true for a sub-group can get completely lost in statistics about the general population.

Malibu billionaires, Kentucky coal miners

The United States is ranked internationally as the 8th best place in the world to get old.

But suppose you’re in the small sub-group of people who have 25 million dollars in assets, happen to live in Malibu, and have unlimited access to the beach, the sun, the best food in the world and the A-team at Cedars Sinai.

If you’re in that group—and believe me, those folks exist— the US is probably the best place in the world to grow old.

But if you happen to belong to the small sub-group of retired coal-miners with black lung disease who live in western Kentucky on government assistance—and believe me, those folks also exist— the US might possibly be the worst place in the world to grow old.

The point is that the averages don’t capture the experience of specific sub-groups.

Taken as a whole, averaging all the numbers, the US is indeed the eighth best place to grow old. True dat. But that average rating simply does not adequately describe the real-life experience of specific groups—like Malibu billionaires or Kentucky coal miners. Their distinct, exceptional characteristics get lost when their numbers are folded into the averages.

Is Cytochrome 450 variation worth exploring? Yes.

Back to the liver and detoxification.

What, if in those thousands of children who were studied for a connection between vaccinations and autism, there was, buried in the data, a small sub-group—just for fun let’s call them Cytochrome P-450-challenged individuals— who just couldn’t “handle the load” of the conventional vaccine?

Overall, looking at millions of people over a decade or more, no causal connection could be seen between vaccines and autism. Of course there wouldn’t be. Millions and millions and millions of people are vaccinated and most don’t become autistic.

But that doesn’t mean that’s the whole story.

Flu shots for all? Not.

It’s not as if we don’t all accept that there are special cases when we don’t recommend vaccines. After all, we tell people not to get a flu shot if they’re: elderly, infirm, or have impaired immunity.

It’s also not as if there’s never been any evidence of harm from vaccinations before.

There’s published research showing a connection between keratitis, an inflammation of the cornea, and the chickenpox vaccine. The reaction is rare, but it happens. Research also shows that 60% of girls given the supposedly 100% safe HPV vaccine, develop a condition called postural tachycardia syndrome. In fact, there’ve been so many reports of adverse effects from the HPV vaccination—including a few deaths—that the European Medical Agency if carrying out a review of the vaccine’s safety.

Correlation is not causation… but still.

Look, let’s be very clear about something. Drawing conclusions about causality when you’re talking about vaccines is almost impossible. And it’s a fool’s errand.

You’re talking about millions of people being vaccinated in all kinds of circumstances, with adverse effects being reported sporadically and inconsistently, and with dozens, ne, hundreds of other variables operating concurrently that could be responsible for any adverse effects. And you have hard data showing that the vast majority of people who are vaccinated aren’t harmed. Drawing any cause and effect conclusions about something as complex as autism would be a statistical nightmare.

I get that.

And I believe that on balance, looked at purely in terms of number of people harmed vs. number of people helped, the public health value of mass vaccination outweighs the cost. More lives are saved than people are harmed.

But that is small comfort to any parent whose child happened to be part of the collateral damage incurred for the greater good.

Is there a “third way”?

Much like American politics, the vaccination issue has created two polarized camps.

On the one hand there’s the “antivaxxers”, many of whom call for a ban on vaccinations and all of whom are dismissed by the establishment as anti-science nut jobs.

Yet many of these people are reasonable, thoughtful individuals who have observed real phenomena in their own homes with their own children, evidence dismissed by the establishment as “anecdotal”. Which it may in fact be, though that hardly makes it irrelevant.

On the other hand, there is the establishment—all the major health and medical organizations—who dismiss any suggestions that the vaccinations might not be completely safe and urge vaccination for all in the name of public health. They suggest we look no further than polio and smallpox for proof of the conventional wisdom on mass vaccinations.

There doesn’t seem to be any middle ground at all.

But maybe there’s a third position, a third way of approaching the issue.

And maybe it begins with giving those who have reasonable questions about vaccines a hearing rather than marginalizing them.

Maybe it begins with the consideration that there are significant individual differences in Cytochrome P450 enzyme systems and detoxification pathways, and that some people might indeed be more vulnerable to ill effects from a safe (for most people) vaccine.

And if there is a group of people who are more vulnerable to ill effects from certain vaccines—just as the elderly and the infirm are more vulnerable to ill effects from the flu shot–wouldn’t it be good to pursue ways to test to see who might be at risk?

That might be a far wiser approach than marginalizing and demonizing anyone who questions vaccination orthodoxy— even when, as I hope this article did, questioning that orthodoxy is reasonable, nuanced, and very much in the spirit of finding answers.