By Don Ford, M.D.
You hear the terms integrative and complementary medicine often used interchangeably in the media as well as the scientific literature. Both terms signify a process of bringing parts together, to unify, or to make whole. That is exactly what integrative or complementary medicine does. It brings together different approaches to strengthen, maintain or reestablish optimal health. Complementary medicine incorporates alternative medicine aspects into mainstream medical practice. The movement towards acceptance of complementary medical techniques is accelerating as the supporting scientific evidence of its different beneficial properties mount and become more recognized. The narrow area of integrative medicine that uses specific supplements within mainstream medicine is perhaps the fastest growing area. As a practicing Internist for the last 22 years, I have always strived to run my medical practice based on scientific, proven treatments whenever possible. That same principle guides the use of alternative treatments that I offer my patients. I have always found it important that my medical decisions be supported by a systematic review of the literature that involves well designed clinical trials that support the efficacy, safety, cost effectiveness and outcomes of the treatment options. Most of these are from well respected, peer reviewed journals. While the scientific data and scientific evidence to support the important role of supplements such as vitamins and minerals in medicine have long been established, it has only been recently that we have seen a significant number of physicians starting to incorporate this knowledge into their day to day practice of medicine. Knowingly or not, these physicians are practicing integrative medicine.
In the information age we now live in, patients are better informed, more empowered and more involved in their healthcare decisions than ever before. Since sources on the internet and elsewhere vary from sound, well respected sites to pure marketing and outright confabulation, it is both crucial and wise to discuss any alternative treatment with a doctor who is aware of what has some science behind it, and what doesn’t. Some patients may no longer see their physician as their primary source of healthcare knowledge and advice, but still view them as a partner in achieving a status of optimal health. A mainstream integrative doctor can provide the best of both worlds with evidence based data to back him/her up.With the huge amount of information out there, it is always wise to seek an objective opinion from a knowledgeable source rather than trust the last infomercial that happened to be on cable television.
I believe that one important aspect of the growth in the interest vitamin and mineral supplements, and in the search for a quality integrative medicine doctor, is due to advances in diagnostic tools to help physicians actually test patients for functional deficiencies of critical vitamins, minerals, amino acids and enzymes that the body requires, not only to provide the minimum amount needed to keep the cell from malfunctioning, but to provide the optimal amounts that make your cells stronger and healthier. When your body lacks the essential raw ingredients that it needs to operate properly, a cascading effect occurs that alters cellular physiology and can adversely affect any or all of your body's systems, and in a worst case scenario, cause them to cease functioning properly. With these new diagnostic tools, physicians now have the opportunity to develop an individualized plan to treat the specific nutritional deficiencies of each patient. The cost of the testing is reasonable and often covered by many insurance plans. It is through technology like this, that physicians and researchers have been able to identify certain “over the counter” and prescription medications that can contribute to specific nutritional deficiencies by either affecting the absorption, distribution or excretion of nutrients. More importantly, it helps understand the negative consequences that the resulting deficiencies may have to your overall health and well-being.
During my career, I have developed a robust interest in the prevention of cardiovascular disease and have always incorporated specific vitamins, minerals and other supplements along with prescription medication to help my patients improve their cardiac health and attempt to avoid future heart attacks, strokes and other devastating cardiovascular illnesses.The evidence behind this approach is extensive, well established and respected, but unfortunately not widely appreciated by many mainstream physicians. In many cases, B vitamins are first line therapy for conditions such as elevated homocysteine, which has become an established marker for an elevated risk of cholesterol plaques or cardiovascular disease.Over the years I have often used supplements such as magnesium for my patients who have certain problems with heart rhythm, high blood pressure, high cholesterol as well as a number of other aspects of health. Fish oil, Coenzyme Q10, various minerals and B vitamins all have a wealth of evidence in the medical literature, and have been a part of my practice for years. More recently, I have discovered that there is a great deal of evidence to support a wide variety of other supplements or nutrients for a variety of problems. Nutritional supplements have always been a complementary part of my medical practice, and may help some patients reduce or potentially eliminate the need for traditional medical therapy entirely. Pharmaceutical companies have over the past few years come out with FDA approved prescription medications that contain only nutrients for diseases such as neuropathy, vascular disease, depression, cognitive impairments such as Alzheimer’s disease, prevention of prostate diseases, and lowering of high cholesterol levels. In essence, pharmaceutical manufacturers have adopted complementary medicine into their business models, and become integrative themselves! I have attended many speaking engagements, many sponsored by pharmaceutical companies, where the speakers spent significant time on the importance of the role that vitamins and other supplements play in the treatment or prevention of cardiovascular disease, or from the prescription medications used to treat those diseases. Well respected speakers such as William P. Castelli, MD, the former director of the now famous Framingham Heart Study for over 26 years, has extensive data to support the use of nutritional supplements to prevent and treat disease, and promote well-being.
With the new diagnostic tools available, I have become increasingly interested in the role of nutritional supplements and how deficiencies relate to many medical conditions. Now that I can develop a specific supplement plan that address patients personal supplement needs, I have found that both my patients and I have a more rewarding partnership in approaching healthcare together.Throughout the years, scientific research has shown that certain medications can cause specific nutritional deficiencies, and with the new diagnostic tools available in my office I have been able to personally confirm the accuracy of the scientific literature that says these deficiencies may indeed occur. Additionally, I have documented complications and symptoms caused by less than optimal levels of nutrients available to the cells of the body. As a result of the testing, many of my patients found they would require multiple supplements in order to replenish several nutritional deficiencies, and this is often at a very high cost. Since insurance companies rarely reimburse for such supplements, these costs are shouldered by the patients themselves as out of pocket expenses.
As I searched for the best options for my patients, I discovered that all nutritional supplements are not created equally! One small change in a nutrient can make a huge difference in whether your body is able to absorb 95% of the nutrients, or only 6%. And once absorbed, it may not be available for the cell to take up from the blood stream if it is not in the preferred form that the cell prefers. Just because both bottles may say, for example, Co-Q10 on the label, the product inside each bottle can be vastly different from brand to brand and even from bottle to bottle within the same brand. What I discovered was the need for my patients to have easy access to pharmaceutical grade supplements that were guaranteed to be high-quality, effective, and safe. Most supplements are not pharmaceutical grade, meaning that there is no FDA oversight and the manufacturer has no legal obligation to follow FDA standards for the manufacture of that supplement. This problem is what led me to join with my partners in integrative medicine to create our Essential-Nutrients line of pharmaceutical grade products for patients that are being treated with specific prescription medications for hypertension, diabetes, cholesterol, arthritis, menopause, birth-control pills, and acid related disorders. Medications for these diseases may cause nutrient deficiencies with long term use that can contribute to side effects or hamper the treatment for the disease the drug was given for in the first place. Now I am able to offer my patients the ability to purchase high-quality, cost effective, safe, nutritional supplements in just one bottle that address the nutritional deficiencies that typically occur together as a result or consequence of certain medications, be it an over the counter or a prescription product. Because of integrative medicine and the Essential-Nutrients line of products, my patients now have access to affordable nutritional supplements that complement their mainstream medical care and enhance health, improve longevity, as well as enrich and improve the quality of their lives. Integrative medicine is a trend whose time has come, and does not discount traditional medicine, but instead builds on it to complement and enhance the patient’s quality of care. C. Donald Ford MD Diplomate of the American Board Internal Medicine.
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