If you get a cold the body can recover on its own, while other illnesses need medication. Why?
In: Biology
Theoretically, given an indefinite amount of time with good circumstances, an immunocompetent person (person with a healthy immune system) could clear out many diseases without medicine. However, we do not have indefinite time, and our circumstances are usually imperfect.
The body launches some non-specific attacks at the initial onset of infection. It takes about two weeks for the body to build up and launch a serious attack that specifically targets the responsible pathogen (virus, bacteria, parasite, etc.). That’s why vaccines and previous exposures can help limit the illness because the body is better prepared and can launch its specific attack faster which can contribute to some illnesses going away without medicine.
Sometimes, resolving illnesses has to do with the scope of the damage. For example, rhinoviruses that cause colds cannot tolerate internal body temperatures very well. They like to hang out in the nasal mucosa, so they are already confining themselves a bit. Influenza, on the other hand, will come for your throat. Specifically, it likes to mess up what’s called the “mucociliary escalator,” a term that refers to these little hair-like projections in cells in your throat that bring up dust and mucous and bacteria from your lungs. While your body is busy fighting off the flu, it’s easy for another disease to slip in. The flu is generally harder to fight off, and in some cases, it can be deadly. It is still possible in many cases to fight it off on your own, but it depends on a combination of what strain it is and how good your immune system is at fighting that strain.
Another factor is how nefarious the pathogen is. Sometimes, we are accidental hosts of pathogens, meaning that we got infected by accident, and the pathogen is not as well-adapted to living in us. Sometimes, these pathogens can be super deadly because they do not have a good way of keeping us alive (which would keep them alive too). For others, it means that they are quickly cleared by our immune system because they were never really pressured to develop ways to get around it. There are some pathogens that infect us to live and get by. These pathogens are generally pretty good at fooling our immune system. One example is Trypanosoma brucei. Humans are not the ideal host since we can still die from it rather quickly, but this parasitic pathogen’s exterior varies often, meaning that as soon as we finally launch a specific attack against it, there’s already some new versions floating around that we have to make another new attack against, and this continues until our bodies burn out. Medicine is pretty much a necessity in this case because the pathogen has figured out how to outsmart our defenses.
Another point to consider is the long-term sequelae or “outcomes” a disease may have. For example, we can generally clear out strep throat (Streptococcus pyogenes) by ourselves. However, there are some strains of Streptococcus that can trigger bad outcomes like rheumatic fever that stays with you for life. Because of this, it is often preferable to try to nuke strep throat with antibiotics before this happens. But as with any illness where antibiotics are prescribed, one has to evaluate the risk of the antibiotic resistance crisis.
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