Psychiatrycels discuss the mayo foid illness fakers / trans question. There's a really good comment from a yt woman explaining what's happening.

>One of _my_ colleagues says that we've solved many of life's major problems but human wiring hasn't caught up. Most of these patients have always had access too clean water, safe, reliable shelter and food, and have not been raised in a war zone. Decent, average family, free from abuse or any extreme situation. No history of trauma. But human development is based on problem solving and we evolved with fear and anxiety responses too keep up safe and alert. Without "real problems" too solve or "real danger" too evade, modern minds are over analyzing and over worrying about small issues and evoking anxiety type responses. Thus, that one time a person felt dizzy becomes a new complaint and they end up seeing three specialists about it and they develop anxiety about it happening again or signifying a more serious problem. In absence of bigger issues too stress over, minor issues get over emphasized. In a world where medical professionals are beholden too insurance and admin, and terrified of getting sued, it's easier too order more tests and send this person down the path of validation as some diagnosis will eventually be met with the excessive workup.

I have read this somewhere?

For almost all of our evolutionary development humans were pretty much covered in bacteria, viruses, and parasitic worms. Velasquez-Manoff refers to this group as "old friends." These are different from the disease-causing bugs we vaccinate against; we got those much later in our evolutionary development, from the animals we domesticated, and Velasquez-Manoff is clear in his insistence that vaccinating against them is necessary and good.

But finding a way to achieve some sort of truce with "old friends" was the immune system's essential and constant job throughout our co-evolution. It is only after the sanitary reforms of the early nineteenth century that we suddenly find ourselves in an environment relatively purged of microbes, and these protective genes may be a liability in that environment, rather than an asset.

The Hygiene Hypothesis

A simplistic view of the hygiene hypothesis is that in the absence of something dangerous to fight against—the cholera toxin, for example—immune cells get confused, or bored, and fight against harmless stimuli like dust mites and peanuts instead. But there is a more nuanced view. Our immune systems co-evolved with an enormous community of microbes, and were in fact shaped by them. Many became established, long-term, and vital residents in our guts; the importance, and in fact the very existence, of these commensals has only recently been realized.

Constant exposure to all of these bugs, as a unit, enhanced the regulatory arm of the immune system, modulating responses so that we could tolerate the filthy environment in which we lived while at the same time (hopefully) fighting off those pathogens that posed a mortal threat and not destroying our own bodies in that process. In the martial analogy that is inevitable in discussing immunology, ancient human immune cells that were always surrounded by microbes were like battle-hardened old soldiers who have learned the ability to watch warily when encountering something new, waiting to see whether or not it is dangerous; modern immune cells raised in our hyper-sanitized environment are like new recruits just given their first gun, testy and jumpy at the first hint of a threat and liable to blow up their surroundings in inappropriately directed and outsized force. Experience has not taught them moderation.

On the molecular level, immune cells in the dirty old days made more anti-inflammatory signaling molecules; now, our cells make predominantly pro-inflammatory signals.

Autoimmune diseases are currently thought to arise from an interplay of genetic and environmental factors, notably stress. Some have argued that this means genes are everything, because what modern human doesn't have stress in his life? Only those genetically primed go on to develop disease.

But Velasquez-Manoff takes us to Sardinia to upend this argument. Sardinians are an isolated, inbred group, and they have experienced a twin epidemic of multiple sclerosis and type I diabetes, both autoimmune diseases, in the past sixty years—ever since they got rid of malaria. For the past few thousand years, those Sardinians that were genetically resistant to the malaria parasite survived; those that were not did not. The relentless presence of malaria in their environment shaped their genomes.

And then when malaria was suddenly removed, its lack may have allowed the immune system's underlying protective feature to go into overdrive. A similar, if less dramatic, trajectory of events could explain how the removal of most of our "old friends," but especially the worms, uncovered underlying genetic tendencies that only yield autoimmune and allergic disorders in our modern context.

Parasitic worms also seem to be significant regulators of the immune system, able to elicit just the right balance of ferocity and temperance. Deworming campaigns the world over are promptly and predictably followed by increases in asthma and allergy, and the degree of allergy in a society is inversely proportional to how wormy and dirty it is. Hence, people suffering from allergies and autoimmune diseases are now infecting themselves with hookworms, which—on an anecdotal level at least—has alleviated maladies ranging from MS to autism to celiac disease.

Yes, he includes autism in the list of modern diseases caused by our out-of-whack immune systems. Along with other cases where immune dysfunction hasn't been established, like obesity, cardiovascular disease, type 2 diabetes, and cancer.

The sanitary reforms of the mid-nineteenth century, along with the germ theory of disease and the vaccines and antibiotics it precipitated, were undoubtedly an enormous medical coup that largely eliminated the infectious diseases that had formerly killed a quarter of the population by age one. We no longer live in fear of the Black Death or similar medieval scourges that killed millions.

But along with these breakthroughs came the idea that all microbes are all bad, which yielded needlessly antibiotic soap and sanitary covers for toddlers sitting in shopping carts. The backlash, that we need to get to know and love the microbiota inhabiting our guts, is yielding Brooklyn hipsters who brew their own kombucha and the very unfortunate anti-vaccine movement. This book argues that microbes are neither good nor bad, but can be either or both depending on the context in which we encounter them. And the real cause of the allergy and autoimmune epidemic is that we have severely screwed up that context, both inside our guts and outside in the rest of the environment.

!bookworms It's all connected?

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