Why Even Good Evidence Struggles to Become Standard Care

A fair question about any emerging approach to chronic illness: if this is right, why is it not standard care yet? The honest answer is illuminating — and it is not the answer the “it’s not proven” crowd assumes.

Medicine is slow by design

Even findings that fit neatly into current thinking take a long time to reach the exam room.

The famous estimate that it takes an average of seventeen years for validated research to reach routine practice is the baseline for simple findings that fit the existing paradigm; for an illness that challenges the paradigm itself, the barriers are higher. — Andrew Heyman, MD

The evidence system fits drugs, not this

Our gold standard — the large randomized trial — was built to test one drug against one disease. It is a poor fit for care that is staged, personalized, and multi-component: remove the exposure, rebuild the gut, retrain the nervous system. You cannot easily blind a mold remediation or randomize a five-phase, individualized protocol.

The economics work against it

There is also money. Binders, botanicals, remediation, and nervous-system training are largely unpatentable — no one owns them, so no one funds the hundred-million-dollar trials that manufacture “standard of care.” Absence of big trials is not the same as absence of truth; sometimes it is just absence of a profit motive to run them.

What honesty requires

None of this means “trust anything.” It means holding two things at once: strong mechanism plus real clinical experience, alongside a candid admission that the large controlled trials mostly do not exist yet. The encouraging part is that the framework defines measurable, healed-state endpoints — exactly what a rigorous trial would need. “Not yet standard of care” is a statement about the system’s incentives and speed as much as about the science.