The Goldberg Clinic

Paul A. Goldberg, MPH, DC, DACBN
Clinical Nutritionist, Clinical Epidemiologist, Diplomate of The American Clinical Board of Nutrition, Certified Natural Hygiene Practitioner

"Causes Identified... Causes Addressed... Health Restored"

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Before After
Diagnosed With
Rheumatoid Disease & Ulcerative Colitis

Physicians told Dr. Goldberg as a young man that he would be permanently crippled by severe rheumatoid disease, accompanied by advanced ulcerative colitis, environmental allergies, chronic fatigue and psoriasis (see picture on left). Through the study and disciplined application of nutritional biochemistry, clinical epidemiology and natural hygiene, he recovered his health (current picture on right).
Since that time, for over thirty years, Dr. Goldberg has successfully helped chronically ill patients from across the U.S. recover from a wide variety of difficult, chronic, conditions by carefully seeking out and addressing the individual causes of ill health.
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For the article as pdf-file (abbreviated) - click here:
Infinite Variety


Infinite Variety: An Introduction To Biochemical Individuality
(Part I)

Hippocrates recognized that "different sorts of people have different maladies."
Ayurvedic medicine designated the classifications - pita, vata and kapha - for the individual and theorized that disease predisposition depends on the extent of these characteristics in each person.
Traditional Chinese Medicine evaluated patients according to their yin and yang traits.

It was among the natural hygienists, however, that the importance of understanding the significance of our individual traits was most completely recognized.

John H. Tilden, M.D. (1851-1940), a reformed medical practitioner and natural hygienist, emphasized understanding each person's diathesis. He contended that when a patient became toxic (ill) for any one of many reasons, it was their diathesis that determined the kind of disease that would be manifested.
The medical model has long held that most diseases come from microbiological factors and/or inevitable inherited traits.
In his book Toxemia Explained, Dr. Tilden acknowledged the role of inheritance (i.e., our diathesis) in predisposing us to disease, but he argued that in most cases our genetics does not seal our fate.(1)
One might avoid the expression of their diathesis by maintaining optimal health, utilizing hygienic/nutritional factors appropriately applied per each person's circumstances.

Today, we understand, from a biological perspective, that disease evolves from two major sources:
  1. The individual diatheses, inherited from the parents, which is the person's genetics or genotype; and
  2. Environmental factors, such as diet, toxins in the environment, contaminants in the water and air, radiation exposure, toxic habits (such as overeating, alcohol, coffee, tobacco), mental influences, injuries, etc.
Our genotype represents our genetic heritage. The manifestation of our genes as influenced through environmental factors is the phenotype. The complete genetic inheritance from our parents is called our genome.

The genome is found in the chromosomes of every one of our trillions of cells. How unique does our individual genome make us? It is estimated that there are 100,000 genes on our 23 pairs of chromosomes. As the science of genetics developed this century, it has brought about a revolution in thinking as new genes and their modes of expression have been discovered.

Each one of us is extraordinarily unique.

The extent of genetic variability is astounding! One egg cell has eight million possibilities in terms of its genetic variability, as does each sperm cell. Therefore, any two parents will produce a zygote with any of 64 trillion (eight million times eight million) diploid combinations. It is no wonder that even brothers and sisters can be so different. Looking beyond a single family, each different set of parents would generate another 64 trillion possibilities. Each one of us is extraordinarily unique.

We look about and witness a vast sea of persons each appearing different from the other. Some are small, some tall, some fat, some thin. There are a variety of skin colors, in tones of black, brown, white, red and yellow, along with different facial features, eye colors and hair textures. The array of differences in outward appearances, however, represents but a glimpse of the variations existing internally with our biochemistry.

In the 1960s, Dr. Roger J. Williams, professor of nutritional biochemistry at the University of Texas at Austin, described "biochemical individuality:"
  "From the practical standpoint, we cannot neglect the facts of biochemical individuality. Of necessity, for reasons involving inheritance, every individual has nutritional needs, which differ quantitatively, with respect to each separate nutrient, from his neighbors. The list of nutrients in the nutritional chain of life is presumably the same for every individual. If we were to indicate the quantities of each nutrient needed daily, however, these amounts would be distinctively different for each of us. Some individuals, in the case of specific nutrients, may need from two to ten times as much as others. Each individual has a pattern of needs all his own."(2)

Our biochemistry is determined by both genetic and environmental factors. We inherit a wide array of traits that determine our biochemistry at birth, which in turn are continuously affected by changes in our environment, such as what we eat, breathe, drink, etc.

The array of differences in outward appearances represents but a glimpse of the variations existing internally with our biochemistry.


Our nutrient requirements and ability to excrete waste products (in adults, detoxification is the major molecule-making activity) depend upon genetic and environmental factors.(3)

Williams and his co-workers observed many differences among supposedly uniform animals in their dietary requirements, along with varying abilities to excrete wastes.(4) Some inbred rats on identical diets excreted 11 times as much urinary phosphate as others; some appeared to need 40 times as much vitamin A as others.(5) Some inbred baby chicks required seven times as much alcohol to bring about intoxication as others; some young guinea pigs required, for good growth, at least 20 times as much vitamin C as others.(6)

Among healthy human subjects, a 200-fold difference has been observed in relation to calcium requirements.(7)
More recent research into mercury toxicity has revealed sensitivities that vary as much as a million-fold from one individual to another.(8,9)

By studying individual traits of newborn animals, the reasons for these differences become more evident. Even among twins, triplets and quadruplets at birth, in a variety of animal species, vast differences are noted. The adrenaline content of the adrenal glands varied within one set of quadruplet armadillos by 32-fold, and since the genes are the same among quadruplets, the inherited differences had to come about through the interplay of environmental mechanisms outside the chromosomal genes, pointing out the interplay of genetic and environmental factors.(10)
These ideas are not new, but the application of them is only beginning to be appreciated.

The understanding of individual traits, from both a genetic and environmental perspective, and the subsequent application of nutritional/hygienic measures permit the potential for reversal of many so-called "incurable" chronic degenerative diseases.

Some argue that genetics determines the level of health we will have. Others contend that it is what we do with ourselves within our environment/habits that makes that determination. Correctly understood, both are involved and neither should be ignored.

There have been specific genes isolated for many different diseases, such as Huntington's disease, cystic fibrosis, breast cancer, colon cancer, cerebral palsy, diabetes and many others. This being true, we would expect to see similar amounts of these disease conditions, as well as lupus, rheumatoid arthritis, diabetes, osteoporosis, etc., around the world, whereas there are people of a variety of racial and genetic backgrounds spread throughout the planet. Epidemiological studies reveal the opposite.(11)

Countless epidemiological studies have clearly shown that the frequency of degenerative diseases varies tremendously from geographic area to geographic area and from culture to culture.

Studies performed in the early 1970s by physician and epidemiologist Dr. Denis Burkitt revealed that colon cancer, appendicitis, hiatal hernia, varicose veins, hemorrhoids, diabetes, obesity, diverticulosis, gall bladder disease and atherosclerosis were far more common in certain geographic areas.(12)

These ailments have mostly been largely attributed to genetics by Western medical science. Burkitt found these diseases prevalent in Western cultures, but those in more "primitive" cultures were largely free from these problems.
When these same individuals, however, moved to Western cultures and adapted the Western lifestyle, they become afflicted with the same disorders. There are a number of environmental factors that may play a role in these types of diseases, but Burkitt found dietary factors to be of significant impact.(13)

Research findings, such as those by Weston Price, D.D.S., and, more recently, from the Framingham study done in the U.S., repeatedly show the epidemiological relationships between diet and other environmental factors and the most common ailments known to Western man.(14)

If people of different races in a particular environment get certain diseases, but in a different environment they are relatively free from these diseases, it can be concluded that the cause of the disease lies in the environment and not in the genetic makeup of different peoples. As one originally trained in public health/chronic disease control and epidemiology, I find it useful to apply epidemiological data about population groups and diseases to individual cases in the prevention and reversal of disease.

When these same individuals, however, moved to Western cultures and adapted the Western lifestyle, they become afflicted with the same disorders. - Burkitt found dietary factors to be of significant impact.


Recognizing the impact that diet and other environmental factors have on our health, we also understand that even under similar environmental conditions not all members of a society develop the same problems. Genetics clearly also plays an important role.

It is, however, one thing to carry a gene for a disease and another thing to have that gene expressed. Clearly, genetics and the environmental factors that allow those genes to be expressed must both be given careful consideration.
Some patients, on their initial visit, relate that they came to see me because they knew another one of my patients who had suffered from rheumatoid arthritis, obesity, chronic fatigue, diabetes, lupus, psoriasis or migraine headaches, and had recovered their health, and that they had the "same condition."

Oddly, however, they often proceed to say that I likely would not be able to help them with their problem, because their mother, father or other relative had the same condition and it was therefore genetic in their case. They come in, therefore, hoping that I might prove their fears incorrect.

This attitude is common among the millions of longtime sufferers of lupus, rheumatoid arthritis, diabetes, colitis, or other chronic diseases who resort to taking symptom-suppressing, health-destroying pharmaceutical agents. They think that nothing can be done for them, since their condition is inherited (i.e., genetic).

It is interesting to observe that few of the many patients seen with serious disease conditions that are considered genetic in origin begin to suffer from these problems at birth. In most cases, the disease does not surface until they are in their twenties, thirties, forties or older. This indicates that while the genetic message allowing the development of the colitis, arthritis, psoriasis, etc., is present, something had to occur to allow that genetic message to be expressed.

It is incumbent upon the practitioner and patient to see how those factors responsible for the expression of the genetic message can be changed and the patient's condition can be returned to improved health.

Dietary and nutritional factors play a key role.(15) What we eat in a single meal has minimal impact on our genetic expression, but long-term dietary choices can have significant impact in the way our genes are expressed. The food does not alter the genes, but it alters the way in which the message from the genes is expressed.

This notion is foreign to most people, as Dr. Jeffrey Bland comments in his book Genetic Nutritioneering:
  "The idea that the foods you eat and the nutrients they contain have the ability to communicate with your genes may be new and strange to you. Information emerging from current scientific research, however, strongly supports that relationship. ... Genetic messages can either be put to sleep or awakened as a consequence of alterations in your diet."(16)

We know, in light of the works of Price, Burkitt, Pottenger, the Framingham study, etc., many of the risk factors associated with heart disease, cancer, diabetes and other conditions. Despite this, these and other disease conditions continue to plague the people of the United States. Why?

Part of the answer is that some people simply ignore warnings not to smoke, drink alcohol, overeat, etc. It is easy enough to understand why those individuals continue to suffer, along with those who are not able to avoid environmental risks, such as air pollution, radiation exposure, etc.

How do we explain why other people, who do not have these risks, still end up battling life-threatening diseases, such as heart disease, cancer, stroke and diabetes or suffering from other ailments, such as rheumatoid arthritis, multiple sclerosis, psoriasis, chronic fatigue, obesity, lupus, etc., that severely and adversely affect the quality of their lives?
The answer is twofold:
  1. The practitioner's lack of knowledge of the patient's biochemical individuality.
  2. Practitioners frequently do not understand what it is that they are "treating."
There is much that we share as a species, such as our needs for water, air, companionship, proper temperature, activity and other basics. General public health recommendations - such as eating a diet based on the food pyramid, exercising 20 minutes four times per week and getting five servings of fruits and vegetables daily - may be fine for the "average person," but they are far too general (or even incorrect), lack specificity and do not even come close to meeting the unique needs of countless individuals who require customized programs of care.

The bookshelves are replete with child care books on how to raise babies as if they all come out of the same little Jello molds - exactly the same. There are countless books on diets, each promoting a certain dietary regimen for the readers' best interests despite the fact that the author does not know any of them. Other books advise a certain diet based on blood type, body configuration, or some other single trait, making no allowance for innumerable other factors that only come out as a result of case histories, physical examinations and appropriate laboratory analyses.

All the general type recommendations, or those based on only one or two characteristics, fail not only because we are all biochemically unique, but also because what is needed for a sick person to get well and what is needed for a well person to remain well are often quite different. All in all, what is lacking is specificity, based upon careful history taking, physical examination and functional laboratory analysis.

Miller and Groziak state,
  "Health professions need to rely less on the universal public health approach and more frequently utilize a selective, informed, process that takes into account individual genetic differences in risk for specific diseases. By identifying genetic variables that affect chronic disease risk and by exploring gene-nutrient interactions, we can evolutionize dietary (or other) advice to best prevent, delay and treat chronic diseases."(17)

What we eat in a single meal has minimal impact on our genetic expression, but long-term dietary choices can have significant impact in the way our genes are expressed.

1. Tilden, John, M.D., Toxemia Explained, Natural Hygiene Press.
2. Williams, Roger, Ph.D., Nutrition Against Disease, 1971. p. 50.
3. MacDonald, S.B., Detoxification and Healing, Keats Publishing, Inc., p. 141.
4. Williams, R.J., et al., "Individuality As Exhibited By Inbred Animals: Its Implications For Human Behavior," Prac Nat. Acad. Sci., 48:1461, 1962; See also Williams, R.J., "Biochemical and Physiological Variations Within Groups of Supposedly Homogeneous Experimental Animals," Symposium on Factors Involved In Host-Agent Relationships, Ames, Iowa, Aug., 1961.
5. Williams, R.J., and Pelton, R.B., "Individuality in Nutrition: Effects of Vitamin A-Deficient and Other Deficient on Experimental Animals," Proc. Nat. Acad. Sci., 55: 126, 1966.
6. Williams, R.J., and Deason, G., "Individuality in Vitamin C Needs," Proc. Nat. Acad. Sci., 55:126, 1966.
7. Williams, R.J., Biochemical Individuality: The Basis For The Genetotrophic Concept, New York: Wiley, 1956.
8. Stejskal, J.S., et al., "Immunologic and Brain MRI Changes in Patients With Suspected Metal Intoxication," Int. J. Occup Med Toxicol, 1995.
9. Stejskal, F.D.M. et al., "MELISA, An In Vitro Tool for the Study of Metal Allergy," Toxic In Vitro, 1994; 8:991-1000.
10. Storrs, E.E., and Williams, R.J., "A Study of Monozygous Quadruplet Armadillos in Relation to Mammalian Inheritance," Proc. Nat. Acad. Sci., 60: 910, 1968.
11. Epidemiology: "The study of the frequency and distribution of disease in a population."
12. Burkitt, Denis, Refined Carbohydrate Food and Disease, 1975.
13. Author's note: Dr. Denis Burkitt worked for nearly 20 years as a surgeon in a teaching hospital in East Africa. During this time, he described a form of cancer which now bears his name (Burkitt's lymphoma). Through his observations and studies, he showed the importance of fiber in preventing many modern Western diseases.
14. Price, Weston, A., Nutrition and Physical Degeneration, New Canaan: Keats Publishing, Inc., 1989.
15. Author's Note: It is important to appreciate that from my viewpoint, factors such as rest, sleep, sunshine, emotional stressors, toxins in the environment, activity, etc., are all part of a person's total nutritional status (i.e., the person's ability to transform nutrients into human flesh).
16. Bland, Jeffrey, Genetic Nutritioneering, Keats Publishing, 1999, p. 34.
17. Miller, G., and Groziak S., "Diet and Gene Interactions," Journal of the American College of Nutrition, Vol. 16, pp. 293-295, 1997.

Factors such as rest, sleep, sunshine, emotional stressors, toxins in the environment, activity, etc., are all part of a person's total nutritional status (i.e. the person's ability to transform nutrients into human flesh).

For Infinite Variety: An Introduction To Biochemical Individuality - PART II continue here

Patient Testimonials               Case Studies
patient testimonials

Video Testimonial
Rheumatoid Arthritis (since childhood), Extreme Pain, Joint Pain, Inflammation, Insomnia, Low Energy

Video Testimonial
Swelling, Numbness, Undiagnosed Neurological Condition, Pain Allover, Pain in Stomach - Legs - Head, Bad Hearing, Tired, No Energy, Bed-bound, Down-and-out

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Multiple Sclerosis, Drooping Face, Extreme Weakness & Paralysis in Right Side of Face, Very Tired, Extreme Pain in Joints & Feet & Wrists & Elbows & Eye, Dizziness, Balance Problems, Chronic Fatigue

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IBD, Colitis, Severe Exhaustion & Fatigue, Raynaud's Disease, Cold Fingers, Cold Feet, High Blood Pressure, Rheumatic Symptoms, Mental Problems

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Juvenile Rheumatoid Arthritis, Pain, Head Aches, Stomach Aches, Pain in Knees & Hips, Weight Gain & Side Effects from drugs

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Severe Allergies, Digestive Problems, Seasonal Allergies, Low Energy

Video Testimonial
Overweight, General Health Problems

Case Story
Skin Disease, "Pityriasis Ruba Pilaris", Severe Dermatological Problems, Itching, Seboric Dermatitis, Melanoma

Case Story
Skin Disease, Systemic Lupus Erythamatosus

at the 2011 NHA conference

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