[PragmaticPulp]

So the author was “prescribed” a cocktail of 5 supplements, found they could eat more protein afterward, and then assumed that Boswelia was the solution? Did I miss something, or did they just assume 1 of the 5 supplements was the solution?

This entire post is a good example of how post-facto reasoning can take over in the space of anecdotal medical changes. The author doesn’t even seem to realize that Boswelia is a notable anti-microbial, which is a nontrivial factor when considering gut issues and potential microbiome changes. Several supplements are potent antimicrobials against the microbiome, some on par with prescription antibiotics. I wouldn’t be surprised if the combination of 5 supplements the doctor prescribed simply nuked their microbiome from orbit and it happened to come back in a somewhat healthier combination. There is precedent for this in controlled studies, but results are very mixed.

The SlimeTimeMoldTime blog they (rightly) criticize is another example of post-facto reasoning taking over at the intersection between “rationality blogging” and medicine: We’ve known for a long time that monotonous diets like potato diets result in weight loss. It’s not magic, it’s just that potatoes are boring and bland and you’re going to eat less food if much of your diet is potatoes. Yet the rationalist community has been doing mental backflips to try to come up with a more complicated explanation for why this might be the case.

[spiffytech]

The author sounds like they methodically tested their supplement intake until they identified the one that produced the change.

The fact that the symptoms returned after they stopped taking the supplements indicates the solution wasn't a one-time microbiome adjustment.

> Back in May the timing of the miracle suggested that one of Dr. Spray-n-pray’s pills was responsible. This was more or less confirmed when I weaned off the various pills and the subtle grossness around food started to return. I could also feel growing sugar cravings. So it was important to figure out what the miracle pill was and get back on it immediately.

> I made a spreadsheet tracking the changes as best I could – when my diet changed (using grocery order data), when I’d started and stopped which pills.

[simonh]

> So the author was “prescribed” a cocktail of 5 supplements, found they could eat more protein afterward, and then assumed that Boswelia was the solution? Did I miss something, or did they just assume 1 of the 5 supplements was the solution?

The author isn’t explicit, but it seems like the pills were prescribed over a period of time, possible separately, possibly overlapping. The author describes using a spreadsheet up correlate which pills coincided with what dietary changes and identifying it that way. So it wasn’t an assumption, but it wasn’t definite either until it was properly tested.

> The author doesn’t even seem to realize that Boswelia is a notable anti-microbial

The author explains that they researched Boswelia and it’s mechanisms of action, so while they don’t explain everything they know about it in the article, assuming they don’t know basic facts about it seems unreasonable.