Do You Feel Lucky?
As a long-time naturopathic physician and after being on the medical school faculty at Bastyr University for over 20 years, I am thrilled to now have the privilege of focusing on the part of medicine that gives me the most joy – working with patients who are motivated to improve the quality of their health. As a new member of the NaturoMedica team, I’d like to share my philosophy and approach to helping patients live longer, healthier lives.
My many years of clinical practice have led me to conclude that being healthy is mostly a calculated bet along with a bit of old-fashioned good luck. A calculated bet is one which is rooted in playing the known odds of being diagnosed with a significant disease. Once you know and understand the odds and the factors contributing to those odds, it’s up to you to decide. Do you want to take action to reduce the odds, or do you want to gamble and ignore the known risk factors and put all your hope into potential medical interventions?
There are well-established odds of developing some of the most common diseases such as heart disease and stroke. Lucky for all of us, we also have knowledge of how to significantly reduce these odds.
Five core principles of Naturopathic Medicine guide my approach to helping patients hedge their bets and delay the onset of many chronic diseases:
- The Healing Power of Nature
- Treat the Whole Person
- Identify and Treat the Causes
- Doctor as Teacher
Keep these principles in mind as we take a glance at the odds with respect to cardiovascular disease.
The recent American Heart Association’s (AHA) publication “2022 Heart Disease and Stroke Statistics Update Fact Sheet At-a-Glance” points out that cardiovascular disease (CVD), listed as the underlying cause of death, accounted for 874,613 deaths in the United States in 2019, and CVD claims more lives each year in the United States than all forms of cancer and Chronic Lower Respiratory Disease (CLRD) combined (1).
Simply stated, it is very likely that nearly all of us will have and quite likely will die from CVD.
I think most of us know of many CVD risk factors such as smoking, obesity, a sedentary lifestyle, poor dietary habits, etc. which contribute to developing CVD. I think we all also understand that we can modify these risk factors and decrease our odds of developing CVD. However, we tend to have the greatest success when we work together with someone who can support us, educate us, treat us when necessary, and possibly shed light on other not-so-obvious risk factors.
This is where our principles of Naturopathic Medicine come into play. At NaturoMedica we focus on treating the whole person, we take pride in educating, we focus on prevention, and we try to identify and treat the cause, all the while trying first to enlist the healing power of nature (natural interventions).
As naturopathic physicians, we investigate and address common risk factors for cardiovascular disease a bit differently than most primary care physicians. Let’s look at common modifiable risk factors through the lens of Naturopathic Medicine:
Most of us know that elevated cholesterol is a risk factor, but did you know that there are many types and attributes of cholesterol and that most often these are not assessed or addressed by most primary care physicians? More thorough laboratory testing, like those that we use at NaturoMedica, can evaluate for these other cholesterols and identify their attributes such as particle size. We employ imaging, such as a coronary calcium CT score assessment (a type of CT scan that can measure the amount of “hard” plaque in the major vessels of the heart), when indicated and use sophisticated, state-of-the-art blood testing for cardiac markers through labs like Boston Heart Diagnostics. All of this allows for a more comprehensive customized and patient-centered approach to the prevention and/or treatment of CVD.
I very often say to my patients, “If for some reason I could only use one metric (e.g., lab values, imaging scans, etc.) to manage my patient’s health and longevity, I would choose blood pressure as that metric.” Uncontrolled high blood pressure can lead to damage and ultimately inflammation of the vessel walls resulting in a cascade of events that lead to vessel obstruction. (Inflammation is a consistent finding at the root of most CVD.) I suggest we all have a blood pressure monitor at home, ideally by the time we’re in our thirties, and take our blood pressure regularly and consistently (stay seated and relaxed for 10-15 minutes before measuring, with legs uncrossed and not speaking). Blood pressure can be modified via diet and lifestyle modification, herbal treatments, or prescription medications.
Elevated uncontrolled blood sugar levels also contribute to vessel damage and inflammation, and focusing on early detection and treatment can significantly reduce this risk factor. Testing beyond the tests that are typically done on annual screening labs can uncover blood sugar dysregulation scenarios that we can address well before a diagnosis such as Type 2 diabetes is made. Vessel damage and inflammation resulting from consistently high blood sugar levels lead to obstructive vessel disease. According to Johns Hopkins Medicine, “People with diabetes are 2 to 4 times more likely than others to develop cardiovascular disease. Because this risk is so high, cardiovascular disease remains the most common cause of death in people with diabetes” (2). More recently, poor blood sugar regulation has even been linked to risk for dementia.
Naturopathic physicians also evaluate other risk factors such as sleep disturbances, more specifically obstructive sleep apnea (OSA), which left untreated can result in a marked increase in heart disease. According to a patient education publication by the American Thoracic Society, “If you have severe OSA that is untreated, you are twice as likely to develop a heart attack in the future as those without OSA. In addition, research shows that up to 70% of people admitted to the hospital because of coronary artery disease were found to have obstructive sleep apnea” (2).
Body mass is yet another modifiable that naturopathic physicians are equipped to treat if necessary. The naturopathic approach to weight loss goes beyond diet to address stress management, physical activity, and sustainable behavior change. At NaturoMedica, we can provide individualized guidance on nutrition, help you discover which foods are best for your body, and identify imbalances that can be a barrier to losing excess weight and improving your metabolic and cardiovascular health. We also offer body composition analysis as part of your routine healthcare visits at no added cost.
Hormones such as thyroid, testosterone, estrogen, and progesterone also play a role in the prevention of CVD, as well as many other processes in the body. From my early experiences working in a urologist’s office to the present day, I have observed the impact that addressing hormonal deficiencies or excesses can have on one's overall health. At NaturoMedica, we offer comprehensive hormone testing to identify imbalances and consider the uniqueness of each patient, allowing for a customized approach to hormone health. It’s rewarding to see patients experience cascading health benefits after re-establishing balanced hormone levels. I have vast experience treating hormone imbalances in a variety of ways, including hormone replacement therapy (HRT).
It’s up to you to decide. Do you feel lucky? Do you simply want to roll the dice regarding your personal health and longevity, or do you want to work with someone who will strive first for prevention (or at least early detection) and who has the ability and knowledge to potentially assist you with minimally invasive and possibly natural means?
I love working with patients who are sincerely interested in doing the work to hedge their bets, and I hope to meet you soon!