In today’s age, it’s common to encounter a myriad of protocols, often promoted by celebrity doctors or health gurus, each promising solutions for various health concerns, from thyroid and adrenal issues to immune system and gut health. But what exactly is a protocol in this context? It is essentially a set of guidelines or rules designed to address specific health issues or optimize well-being. These protocols often come with dietary restrictions, supplement recommendations, and lifestyle changes, often promising miraculous results. Although this nomenclature may seem to signal scientific rigor, these types of protocols are quite different from the extraordinarily prescriptive protocols used in research studies and clinical trials.

When the medical system leaves patients with chronic multisystem invisible illnesses disempowered and desperate for validation, answers, and relief, it is easy to understand how the allure is so powerful. When navigating uncertainty within the context of rampant diet culture, adhering to a rigid “to-do” and “to-don’t” list can seem strangely comforting. Desperation can drive even the most scientific of us down the rabbit hole of health protocols – myself included.

However, the consequences of blindly following such protocols can be significant. The allure of a so-called superfood supplement “protocol” that was supposed to improve my fatigue and pain caused by my autoimmune disease seemed harmless enough. Ultimately, after 8 weeks of daily dedication to a green protein powder-based smoothie and a berry-based drink, it resulted in a yellow hue to my skin and eyes, uncontrollable itching, and dark-colored urine. I had developed an acute liver injury requiring an invasive biopsy. Sadly, I’m not alone in this; it’s estimated that 20 percent of hepatic injuries in the United States result from unregulated herbal and dietary supplements.

Another common element of many protocols includes a strict elimination diet in an effort to see if particular foods may be triggering symptoms. Although the vast majority of protocols recommend that these elimination phases should not be maintained for long periods of time, I have witnessed both personally and professionally their tendency to unearth disordered eating behaviors – like restriction and food fears. Orthorexia, an unhealthy obsession with eating only “clean” foods while avoiding anything deemed harmful, is a common issue for those with IBS-like symptoms. Strict elimination of entire food groups often leads to an increased risk of malnutrition, higher food costs, reduced diversity in the gut microbiome, and immense stress, especially when navigating social situations.

The reality is that a portion of people will have success with these protocols. By recalibrating and refocusing on new daily habits like eliminating highly processed foods and replacing them with nutrient-dense options, minimizing stressors, incorporating exercise, and getting a good quality and quantity of sleep isn’t terribly surprising! These are evidence-based lifestyle recommendations, after all. That said, these anecdotal successes are promoted while easily hiding and silencing any social media critiques.

So what should we be doing? I advocate for thinking critically.

Here are the questions I recommend you consider:

• Who is making this recommendation? What are their credentials? Determine the expertise and qualifications of the individual endorsing the protocol. Be cautious of those with credentials who are making recommendations outside their scope of practice.
• What are the costs involved? Consider not just the monetary expenses but also the time and energy required. Assess whether it may adversely affect your mental health or overall well-being.
• What is the evidence? Investigate whether the protocol has undergone rigorous scientific scrutiny. Are the results purely anecdotal, or do they stem from well-conducted clinical trials, ideally with a control group? Look for studies involving individuals with similar profiles to your own.
• Was this protocol reviewed by an Institutional Review Board (IRB)? An IRB ensures that research protocols are ethical, safe, and free from biases. This approval lends credibility to the protocol’s safety and scientific rigor.
• What do my doctors/health care team members think? It is important to touch base with your health care team prior to making any substantial lifestyle changes – whether protocol-based or otherwise – as significant changes may require medication adjustments and drug/supplement interactions need to be considered.

Moreover, be on the lookout for red flags:

Overblown claims. Be skeptical of protocols that promise a cure, miracles, breakthroughs, or secrets. Health is complex, and simple solutions are often too good to be true.

One-size-fits-all. Protocols that claim to work for everyone with a particular condition should raise suspicions. Health is highly individualized even within the same disease process.

Proprietary supplements. If a protocol insists on specific supplements only available through the recommending party, exercise caution.

Lack of insurance coverage. Consider whether the protocol may result in significant out-of-pocket expenses, as this can be a financial burden. In some instances, this may signal that the scientific evidence is not quite ready to support this treatment.

In conclusion, health protocols can be enticing in times of desperation, but they must be approached with caution and critical thinking, similar to how we would approach starting a new medication. A personalized evidence-guided approach, based on sound scientific research and tailored to your unique needs, often holds more promise for genuine health improvements. Don’t let the allure of quick fixes blind you to the potential risks and costs associated with blindly following protocols.

Kara Wada is a quadruple board-certified pediatric and adult allergy and immunology, lifestyle, and functional medicine physician, a Sjögren’s disease specialist, and a Sjögren’s patient herself. She spent nine years on faculty at The Ohio State University Wexner Medical Center, where she served as associate program director of the allergy and immunology fellowship and led the Mast Cell Center of Excellence.

In 2025, she left academic medicine to build the kind of practice she could not find as a patient: the Immune Confident Institute, a national direct-care immunology practice licensed in 27 states. She treats the patients the health care system sends ping-ponging between specialists, people with complex, chronic, multisystem disease including mast cell activation syndrome (MCAS), dysautonomia, Sjögren’s disease, immune dysfunction, and the seronegative and “in-between” diagnoses that do not fit neatly into a single specialty.

Her premise is simple: These patients are not the problem. Fragmented care is. Medicine has become exceptionally good at looking through microscopes while losing sight of the telescope, the bigger picture of the person in front of us. Her work challenges a health care culture that demands compliance when it should assume competence, and aims to make strategic, compassionate immune-directed care the standard, and the exam room a place where patients are finally seen, heard, and believed.

Most of her reach is built outside the exam room. Her YouTube channel drew roughly two million views this past year, and more than 100,000 people follow her work across platforms, including a Sjögren’s community of about 6,600. She founded and hosts the Virtual Sjögren’s Summit, now in its sixth year and drawing some 4,300 registrants worldwide. She appears regularly on national television and in the health press, including Prevention, SELF, Good Housekeeping, WebMD, Medscape, and MedPage Today, and she writes for KevinMD on the diagnoses that live in the shadows and the medical gaslighting that surrounds them.

A TEDx speaker and sought-after keynote, Wada speaks to clinician and patient audiences about complex immune disease, the experience of being disbelieved, and what changes when the physician is also the patient. She is also an unlikely pageant titleholder, having served as Dr. Ohio America 2022 and Dr. Midwest America 2023, and has written about how pageantry sharpened skills medicine rewards but rarely teaches.

She earned her medical degree with honors from the University of Illinois College of Medicine at Peoria and completed internal medicine-pediatrics residency, allergy and immunology fellowship, and clinician educator fellowship at The Ohio State University and Nationwide Children’s Hospital. She lives in Columbus, Ohio, with her medical school sweetheart turned husband, Akira, and their three children.