Considering the variety in the human race, height, weight, temperament, enzymatic capacity,
it is amazing that pharmaceuticals work at all. Add environmental factors, and personal
preferences, and suddenly you begin to realise the scale of the problem. Some years ago I
ran a clinical trial in patients with ulcerative colitis. When I was recruiting the subjects, I
asked people to keep a diary of everything that they ate. Even within the catchment area of
Queen’s Medical Centre in Nottingham, the diversity of food eaten, let alone the frequency
of eating, was beyond comprehension. This led me to think about the world outside
Nottingham, eating habits within the UK, the north/south divide (which we are assured by
the Government does not exist) let alone what people eat in Africa, China, Fiji......?? Then
remember that medication is designed for sick people, who by definition have a physiology
disordered in some way. So how can one pill fit all?