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DR. MARK’S INTEGRATIVE MEDICINE CABINET: Holistic lifestyle a healthier alternative to drugs
JACKSON HOLE, WYO – Can we reverse diabetes? Can we stop this epidemic of disease? Will one in three children born today really develop diabetes in our lifetime? Will this be the first generation to live shorter lives than their parents?
The answer is YES to all of these questions. In the next 20 years we will double the number of people with diabetes (currently estimated at 100 million Americans) which will triple the cost of care (currently $113 billion). How will our economy survive, what quality of life are we leaving our children, and will we have the ability to deliver health care any better than we are delivering it now?
We need a change. There is a new approach to healthcare that utilizes an Integrative Medicine approach called Functional Medicine that is actually quite simple and very intuitive. Most illness and disease really come from very few original causes that are treatable when viewed in this biological and functional way. The name or definition of a disease, for me, becomes less important than correcting the internal imbalances that give rise to the symptoms presenting as the disease. If a disease is primarily a nutritional, metabolic or lifestyle disorder, why do we keep seeking out new drugs to treat risk factors, instead of addressing these basic functional mechanisms? The next blockbuster drugs will not be disease modifying drugs but will be a mechanism modifying process.
We are currently asking the wrong questions about how to treat illness. We are treating the symptoms and not treating the cause. At a recent conference I attended, a physician showed a slide of four doctors mopping up water from a sink while the faucet was still running – our current approach. I propose we use diabetes as a model to change the way we approach all chronic illness. We need to find ways to turn off each individual’s faucet and stop mopping the floor. Let us try to understand that symptoms and illness have purpose for us and is our body’s sign that it is trying to correct underlying imbalances or dysfunctions. Instead of using medications to only try to block or interfere with these now abnormal processes, why not try to teach and help each individual promote normal function to repair processes that are out of balance? Symptoms and illness are clues to deeper metabolic, lifestyle and environmental imbalances that can be corrected utilizing an Integrative Medicine approach. But our current medical model is not set up properly to identify and correct these imbalances, and it is especially unable to take the time to do this.
When I was in my medical residency, our daily goal (I called it the daily grind) was to see a patient every seven minutes over an eight hour day to try to see over 40 patients per day. This model works great for symptom management and medication dispensing, yet it fails us when we actually want to help someone heal. That model was Rene Descartes reductionist model of care, which works well in pharmaceutical approaches to care. See high blood pressure, take a drug; high cholesterol, take another drug; high blood sugar, yet another drug. These numbers are just risk factors – downstream markers from the real causes. Treating these risk factors alone with drug therapy will fail us in our goal of understanding and correcting the underlying causes that drive the continuum from elevated numbers and risk factors to full-blown disease. I propose that this model of care is failing us. An example is a study from 2008 of the drug Lipitor. The drug therapy caused up to a 9 percent increased risk of diabetes from the drug itself. The drug Avandia that treats diabetes has killed over 40,000 people and was taken off the market in Europe as it can cause a heart attack – just the thing we are treating diabetes for to prevent! This is a great example of the outdated model of current care. We can use this potential epidemic of diabetes to create a functional approach to health to prevent the burden of this disease, as well as develop a model for treating all chronic illness.
A systems approach can look at risk factors that identify patterns and treat them at their root cause to correct the imbalances showing up as symptoms and illness. We need to move forward beyond risk factor treatment and toward correction of the underlying causes of these risk factor changes. We do this by addressing the upstream causes in an individualized, comprehensive, systematic approach and by utilizing an Integrative Medicine model – assessing functional deficiencies of mind, body, spirit and earth is the key to success.
Two fascinating examples are my experiences from medical residency rotations observing gastric bypass surgery and liposuction surgery (fat removal). When a 400-pound patient had gastric bypass surgery, within a week, the body normalized elevated cholesterol and triglycerides, reversing the patient’s previously elevated blood sugar. The patient still weighed 400 pounds, so it is not just weight loss that can fix these problems. Something else is at work. Another example is a patient that underwent liposuction and had 40 pounds of fat removed – instant and dramatic weight loss. Her blood pressure, blood sugar and cholesterol/triglycerides did not change at all over the next month.
Why? Food is information to the body. A new concept of Nutrigenomics is emerging that the foods we eat – both good food and the processed, toxic foods we are exposed to – provide the body with information and cues that work as metabolic and molecular “switches” to turn on mechanisms that can lead to health or to illness. Think of food as more than just a source of energy with all calories being equal. The quality and source of our carbohydrates, fats and proteins are crucial to turning off the bad switches and keeping on the good switches. Eating whole foods that are beneficial to genetic expression in a good way, as well as cellular functioning in an optimal way, are keys to health. Most of us are lost in the “supermarket forest” and have lost our hunter/gatherer skills to raise healthy, organic foods; we have less love in our lives and less sense of family and community.
So can we reverse this epidemic of diabetes? Yes. First understand that diabetes is a continuum that starts with dysregulation of blood sugar, leading to insulin resistance, then to metabolic syndrome, and finally to diabetes. The typical American lifestyle of highly refined, processed, high sugar/low fiber/high fat foods coupled with sedentary lifestyle filled with chronic stress bathed in a toxic environment is the recipe for future disaster. These trigger secondary dysfunctions of nutritional deficiencies, inflammation, hormonal disruption (particularly thyroid and estrogen), digestive imbalances, oxidative stress and mitochondrial dysfunction. This is the root of all disease, and you must treat all the risk factors of high blood sugar and high cholesterol. Treating risk factors is less important than treating the patterns they form at their root.
So when you go to the doctor, do some research first, develop a relationship with a caring provider, ask the questions you need answers to and be heard. Yet first, look at your own behaviors that you can correct so that you never need the medications that are increasingly shown to be dangerous and perhaps not beneficial. Develop a holistic lifestyle as above and restore those healthy relationships with a stronger sense of community that benefits us all.