From the Doctor’s Desk: Health and Wellness Defined

Definitions.

Health can best be defined as the absence of disease.  Wellness is best defined as the existence of positive health.  So health and wellness can be best defined as the absence of disease in the presence of positive health.

Why the focus on health and wellness these days? I think modern medicine gets a failing grade. Obesity is epidemic in the American culture today. One of my patients knew that her weight was not healthy. However, her previous physician told her that she should learn to live with her new heavier weight and maybe the weight would level out. That statement haunted her and led her to find a physician who offered her more hope and solutions.

Health and wellness cannot be achieved through a traditional, allopathic (Western modern medicine) medical approach. Why? Western modern medicine (we’ll call it traditional for our purposes) uses a disease-focused model utilizing pharmaceuticals. Pharmaceuticals block biochemical reactions, produce mitochondrial toxins, and deplete important nutrients. There is no positive health there.

In fact, the 4^th – 6^th leading cause of death is from prescription drugs (Mol Aspects Med. 2005 Aug-Oct;26(4-5):363-78). In contrast, functional medicine is a health and wellness model utilizing natural substances found in the body to enhance cellular processes. A health and wellness model looks to work with the body, to facilitate metabolic reactions and optimize physiologic function (The principles of metabolic therapy for heart disease. Heart, Lung and Circulation 2003; 12:S55-S62).

In some ways, the two are complementary; but in many ways, the two are not. I am not advocating a boycott of traditional medicine. In fact, I still practice some traditional medicine when disease exists.

The key is this — does disease exist or not?  If disease doesn’t exist, and health and wellness or health restoration is your goal, then a functional or integrative approach is the way to go to facilitate and optimize physiologic function.

So, what is a functional medicine approach?  To help define functional medicine, let’s look at a few examples.

The traditional medicine approach.

Metformin or Glucophage is a well-recognized drug used to treat diabetes.  Metformin works to improve insulin sensitivity and thus facilitate glucose uptake inside the cells.  Type II Diabetes is marked by very poor insulin sensitivity and thus blood sugar rises.  Traditional medicine prescribes Metformin to provide a 13% improvement in insulin sensitivity.

Remember, pharmaceuticals block biochemical reactions.  Metformin reduces folic acid and vitamin B12 and can elevate homocysteine. Elevated homocysteine levels increase blood clot risk (this is one of the ways that birth control pills increase blood clot risk).  Diabetics and those with insulin resistance are already at an increased risk of blood clots. Can you see how the treatment is piling on in this situation?

The functional medicine approach.

Let’s contrast that with a functional medicine approach. Vitamin D deficiency is rampant today. Vitamin D deficiency has been implicated in heart failure, myocardial dysfunction, sudden cardiac death, and is required for normal insulin release and glucose control.  Remember the 13% for metformin? Higher vitamin D levels resulted in a 60% improvement in insulin sensitivity (Chiu K., et al., “hypovitaminosis D is associated with insulin resistance and beta cell dysfunction,” Amer Jour Clin Nutr  2004).

Remember, functional medicine works with and facilitates the body’s functions. Vitamin D does not block any biochemical reactions, nor does it interfere with any. Thus, there is no negative effect comparable to Metformin. Now, too much of a good thing can be a problem. Too much Vitamin D can elevate calcium. Because of this, Vitamin D should be prescribed under the watchful eye of a physician.

Why do I do what I do?

Amazing results — as naturally as possible. This is why I practice functional medicine. This is why I created Seasons. A health and wellness model, through functional medicine, works with the body to enhance and optimize physiologic function.  Health and health restoration can only be achieved by working with the body. Let’s get out of the way and let the body heal itself.

What is Metabolic Syndrome?

Metabolic syndrome is a collection of conditions that occur together to increase a women’s risk of heart disease, peripheral vascular disease, stroke, and type II diabetes.

It isn’t a disease, so much as a collection of conditions. However, it can still be dangerous if left untreated, possibly leading to the diseases listed above: peripheral vascular disease, heart disease, stroke, and type II diabetes.

The identification of metabolic syndrome provides a window of opportunity for treatment to prevent disease.

The following risk factors co-exist in metabolic syndrome…

• abdominal obesity
• blood fat and cholesterol disorders
• elevated blood pressures
• insulin resistance
• pro-blood clot state
• pro-inflammatory state

Abdominal obesity and insulin resistance are the dominant risk factors. Other conditions that affect metabolic syndrome include physical inactivity, aging, hormonal imbalances, and genetic predisposition.

Since it isn’t a disease, we diagnose metabolic syndrome by looking for co-existing symptoms. Any three of the following are required to meet the classification of metabolic syndrome…

• abdominal obesity (waist circumference >35 inches)
• elevated triglycerides (>150)
• low HDL (<50)
• elevated blood pressure (> 130/85)
• elevated fasting glucose (>110)

Metabolic Syndrome is not uncommon. It is estimated that over 50 million Americans have it. We treat it by managing a patient’s weight loss, increasing physical activity, treating hypertension, prescribing daily aspirin therapy to reduce pro-blood clot states, and treating elevated triglycerides and/or low HDL levels.