by Dr. John Neustadt

Humans have created sophisticated explanations for diseases, defining the mental, emotional, physical, nutritional, genetic and spiritual components of health. The incredible knowledge we’ve gained from science over the past century has revolutionized laboratory testing and imaging studies (eg, MRIs, CT scans) and provided a new level of detailed information we’ve never had before. At the same time, antibiotics and other drugs have been incredibly effective at saving lives. But  conventional medicine has become so reductionist and so dependent on medical specialists and medications that many people aren’t receiving the medical care they need. For too many patients, only part of what is making them sick gets treated, and the underlying causes of their diseases are rarely addressed.

Consider these alarming facts:

• According to the Henry J. Kaiser Family Foundation, pharmacies fill more than 4 billion prescriptions for medications every year. That’s nearly 13 prescriptions per person in the US.
• Nearly 60-70% of American take at least one prescription drug.
• Nearly 2,500 people die every week from properly prescribed medications.
• Side effects from medications cause 1.5 to 2.7 million hospitalizations every year.

Not only that, the care that’s delivered is incredibly expensive, has a lot of side effects, has the worst outcomes in the developed world and is killing people. According to a 2016 U.S. News & World Report article, properly prescribed medications may be the fourth leading cause of death in the US. Despite the fact that the US spends an astounding 18% of its Gross Domestic Product (GDP) on healthcare, for the fifth time in a row the Commonwealth Fund reported that the US healthcare system comes in dead last when compared to other industrialized countries in “efficiency, equity and outcomes.”

How Medicine Defines You

The most fundamental rule of medicine that all medical students learn is, “First, do no harm.” But the reality is that the conventional approach to medicine is hurting a lot of people. One of the reasons why conventional medicine is gettng such poor results is because how medical schools teach students to view patients, health and disease is fundamentally flawed.

Conventional medicine has created a system of diagnosis that meets its needs and the needs of the pharmaceutical and insurance industries. The reductionist model used by physicians is based largely on symptoms and rarely based on causality. For example, a diagnosis of depression is merely based on symptoms (eg, you tell the doctor your energy is low, you feel hopeless or helpless, etc.) and signs, which are what the physician observes (eg, flat affect, slow speech, etc.). There can be many causes of depression. Doctors will usually only do a very cursory evaluation which might include a thyroid test, a complete blood count and a serum chemistries, and ask you if you’re not sleeping well, if you’re under excessive stress or if there are some life situations causing your depression.

If all of those tests and questions don’t confirm any particular diagnosis other than depression, then doctors frequently just prescribe an antidepressant. Many times the antidepressant really doesn’t help, and in fact may compound the depression even more. A January 17, 2008 report from the New England Journal of Medicine (NEJM) titled, “Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy” revealed that antidepressant medications really only work 40-50% of the time. Manufacturers of all antidepressant medications on the market biased their study data and refused to publish data that went against their corporate interests. The effectiveness of these medications was thus artificially inflated by nearly 70% in the case of Serzone and by 64% in the case of Zoloft. Consequently, doctors and patients are getting a distorted view of the usefulness of antidepressants like Effexor, Zoloft, Welbutrin, Paxil, Remeron and Prozac.

Many of the underlying causes of depression, however, are very well defined and can be tested for and quickly corrected. The biochemical pathways in the body that influence mood, and how toxins, infections and allergies affect mood, are all very well defined.

The questions physicians ask and the tests they run are important to rule out low thyroid function and emotional and lifestyle factors. However, this line of reasoning misses many important underlying causes of depression, including deficiencies in amino acids, magnesium, manganese, iron, B-complex vitamins, coenzyme Q10 and alpha lipoic acid; accumulation of toxic metals such as lead or mercury; problems regulating blood sugar due to any of these nutritional deficiencies and poor diet; food allergies; and infections, commonly intestinal infections. In fact, there’s ample evidence for using food as medicine and nutritional approaches to boost many areas of health, including mood.

What’s required to improve mood is to view patients holistically. To help them with appropriate counseling, cognitive behavioral therapy or eye movement desensitization and reprograming (EMDR). To get them exercising and improving their sleep. And to provide that the nutrients that feed energy and mood pathways in the brain through improving the diet and taking dietary supplements.  There’s no incentive for the pharmaceutical industry to really develop effective treatments because it goes against their financial interests. And since the pharmaceutical industry defines most of the medical education in this country, conventionally educated physicians never study the underlying biochemical causes of diseases.

While the effects of specific nutrients and pathways of depression are well documented, conventional medicine ignores them. Instead of providing customized treatments based on a person’s specific biochemical needs, conventional medicine adopts a one-size-fits-all approach to depression by prescribing antidepressant medications. These medications fall into two classes—selective serotonin reuptake inhibitors (SSRI) and selective serotonin and norepinephrine reuptake inhibitors (SNRI). Examples of SSRI medications include Zoloft, Lexapro, Celexa, and Prozac, and an example of a SNRI medication is Welbutrin.

Many people turn to stimulants and short-term solutions to lift their spirits and energy such as alcohol, sugar, caffeine, cocaine, methamphetamines, and Ritalin. These substances provide brief relief from the symptoms of fatigue, but in effect they make the underlying causes of the problems worse. For example, sugar directly stimulates a release of serotonin in the central nervous system, thereby lifting mood, and it also provides fuel for energy production. The problem is that eating sugar also stimulates insulin release because insulin’s job is to help move sugar from the blood stream and into cells that use the sugar for energy. But when this happens, blood sugar drops and the person becomes hypoglycemic (having low blood sugar), which manifests itself in the symptoms of irritability, restlessness, insomnia, fatigue, and depression. The paradox here is that even though people feel fatigued, they also feel restless and may have insomnia because of the subsequent low serotonin and melatonin.

There is another irony here. Most people who feel depressed and tired often drink alcohol to sleep, but within a few hours they wake up with increased irritability, restlessness, and insomnia, which can become intractable since the more they feel these symptoms the more they want to drink in order to eliminate them. The alcohol itself is a central nervous system depressant, but it’s also just fermented sugar, and alcoholic beverages therefore contain high amounts of carbohydrates. The rebound effect on mood and energy is explained by the same mechanisms as sugar itself. When blood sugar drops too low during sleep, it stimulates the release of cortisol and epinephrine. These hormones cause the release of stored sugars in the body to raise blood sugar, but they also wake people up. The more someone drinks and the more someone eats sugar to lift their mood, the more their problems are compounded because of the resultant hypoglycemia.

An additional factor is that as people eat more sugar and drink more alcohol, the consumption of nutrient-dense foods containing essential vitamins, minerals, and amino acids decreases. So if the cause for depression and fatigue is a deficiency in the compounds required for healthy neurotransmitter production, masking the symptoms by consuming sugar, alcohol, and other substances that provide a short-term boost in mood and energy actually worsens the depression and fatigue. This becomes a vicious cycle that people have great difficulty breaking out of because the withdrawal effects can be more severe than the addiction.

The diagnosis of depression, just like other diagnoses such as irritable bowel syndrome, arthritis, asthma, obesity and restless leg syndrome is simply based on gross signs and symptoms. And some diagnsoses, like osteoporosis, are not made based on any symptoms. A diagnosis of osteoporosis is based on the results of a bone density scan. The analogy I like to use is that if you’re in an airplane flying over a large city, you may be able to tell that there’s a traffic jam on the highway, but the reason why remains a mystery. Similarly, your symptoms are the 50,000-foot view, but biochemical evaluations can likely answer the crucial question, “Doctor, but why do I feel this way?” Unfortunately, most patients are so relieved once they receive a diagnosis that they usually don’t go beyond that point and ask, “Why? What are the underlying causes and what can be done about them?” And doctors seldom ever go beyond their diagnoses to ask themselves, “Why?”

More than Just Lack of Disease

Health is a sense of wellbeing that is defined by three different time elements: your past actions and you and your family’s medical history, your current health and the risks for future problems.

The past defines what your family and you have had and may provide information about your risk for future illnesses. For example, one of the most important predictors of breast cancer in women is if the woman’s mother had breast cancer. Similarly, if a parent or a sibling had or has any cancers, diabetes or heart disease, you are automatically in a higher risk category than people whose immediate family does not have these conditions. It may be that you have a genetic predisposition to these conditions, but more likely it’s because family members tend to follow the same lifestyle and dietary pattern—lack of exercise, poor diets and high stress. Research suggests that 80% of large bowel, breast, and prostate cancers are caused by poor nutrition, physical inactivity and obesity. And the predominant causes of heart disease and diabetes are the same.

When I hear people exhibit a fatalistic attitude by saying that their heart disease or any other condition is just “genetic,” most of the time it’s simply a rationale for them not taking responsibility for their own health. The reality is different. While genetics are important, as we age lifestyle and dietary factors become even more important. Rationalization is an underappreciated dynamic and is far more powerful than people realize. Rationalizations allow people to explain away their responsibilities for taking care of their own health. My passion with NBI and in educating people is to try to break through people’s rationalizations and inertia to help motivate and empower them to identify and break bad habits and excuses.

Your own past medical history provides extremely important information about what your current condition may be, but also what you may be at risk of getting in the future. For example, if you frequently suffered from ear infections as a child and were put on repeated courses of antibiotics, you may now be at increased risk for intestinal infections, called “intestinal dysbiosis.” These infections are commonly caused by bacteria and, when caused by yeast, they’re referred to as intestinal candidiasis. Symptoms of this condition include gas and bloating; post-nasal drip; headaches; brain fog (difficulty processing information); diarrhea or constipation; and in more severe cases rashes, muscle and joint aches.

Similarly, if you have had a history of any cancer, you are at an extremely elevated risk another cancer. But if you follow a whole-foods, plant-based, low-fat diet; exercise; and practice stress reduction, you may reduce your risk of another cancer.

The final crucial components of evaluating your health risks have to do with understanding and taking inventory of your past and present environmental exposures, dietary and lifestyle considerations and medications. Environmental contamination has become a serious public health problem. Eighteen drinking water studies have linked aluminum level to elevated risks of Alzheimer’s disease and cognitive impairment in the elderly. Between 50,000 and 100,000 synthetic chemicals are being produced commercially around the world.

Health is determined over time, the condition of your body and your state of mind. Each of these are interrelated by biochemical interactions, which can all be altered by stress, exercise, pharmaceuticals, nutritional deficiencies and environmental toxins. Changing your biochemistry may not create symptoms immediatley, but damage can accumulate from multiple sources over time, eventually tipping the balance toward disease. Alterations in your biochemistry can cause symptoms such as headaches, strokes, depression, fatigue, cancer, eczema and fibromyalgia.

The Polypharmacy Phenomenon

Polypharmacy means taking multiple drugs at the same time. Usually people end up taking five or more medications for the major chronic, degenerative diseases, such as for high cholesterol, diabetes, high blood pressure, depression and arthritis. They may be taking Lipitor, Lisinopril, Lexapro, Metformin, Celebrex and others. What each of these drugs do is to attempt to treat a symptom. Not one of these drugs actually treats the underlying causes of these symptoms, and none of them stop or reverse the underlying conditions, which progressively get worse with aging.

What is happening is that doctors are not looking at you as a whole entity. Instead, they are chopping you up into piecemeal components and treating each component separately and as if they are not connected. The analogy is that if you were hemorrhaging the doctor is putting small bandages instead of identifying and correcting the underlying cause of bleeding. Now admittedly, the medical field has done an excellent job with dealing with acute crises or traumas. Conventional medicine has had a much harder time being able to understand the degenerative, aging process, and specifically how it pertains to the entire body. Conventionally trained physicians are not taught to integrate different body systems and to think or treat people holistically. Nor do they receive comprehensive classroom and clinical education concerning nutrition or lifestyle factors of disease. What they are experts in is drugs and surgery, but even there the majority of the time these interventions merely treat symptoms and not the underlying causes.

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