Sarasota, FL
Alan J. Sault, MD, ABHM, PA
941-927-6797
Integrative Medicine:
Frequently asked questions and additional information.
(Click on the links below for more information on the following subjects and questions.)
Complementary, Alternative, Holistic: What's the difference?
In popular usage, and in many academic circles, the terms complementary, alternative, and holistic, are often used interchangeably, but there are important differences between them.
Complementary medicine is, as it states, the use of other methods along with traditional western (allopathic) medicines. Alternative medicine is when one breaks away from the conventional allopathic treatments and uses other types of treatments only, such as Ayurvedic medicine, herbs, acupuncture and so on. Holistic medicine treats not only the specific physical symptoms of disease, but the whole patient by servicing the trinity of mind, body and spirit. The physician and patient are equal partners in the healing process. The patient takes responsibility for his or her own health and uses the physician’s knowledge and experience as guide and life-guard. I consider the term integrative medicine to be synonymous with holistic medicine in that it seeks the appropriate combination of therapies for a particular patient and illness, within the context of the mind/body/spirit totality.
The holistic physician needs to spend time with the patient, because a large part of holistic practice is listening to what the patient is not saying, as well as what the patient is saying. This must be done with as much non-judgmental unconditional love of which the physician is capable, since many illnesses are caused and prolonged by emotional stress. Holistic medicine has as its goal not only the alleviation of symptoms but also the creation of a healthy way of life.
There is the perception among some people that by serendipitously using botanicals and supplements they are living a healthy life style. True, they may be doing better than if they were not trying at all, but they may be headed for danger. Botanicals are medicines, and like any other medicine they can have side effects. Certain botanicals need to be taken in proper dosages, which may be different for different maladies. Taking too much can cause toxic side effects; taking too little can mean there are no benefits. This also holds true for supplements. And just like a medical text, a botanical text does not take into account individual differences that must be evaluated by an educated, caring professional. Otherwise, there is little difference between indiscriminately writing prescriptions and recommending botanicals and supplements.
Developing the art of patience allows the physician to relate on all levels: mind, body and spirit. Sometimes botanicals, supplements, and allopathic drugs are not the answer. The answer may lie in alleviating the stress that is causing or giving energy to the illness. Sometimes the illness has something to teach the patient. All these things are a part of holistic medicine, which may require a referral to another professional with expertise in different types of mind, body and spiritual techniques. Again this is done with the informed consent of the client.
It is the patient teaching the physician and the physician teaching the patient that makes holistic medicine such a wonderful relationship devoted to the process of evolving and living without disease.
Over time, as a result of what we ingest and breathe, the walls of our blood vessels can begin to accumulate plaque (atheroma), composed of cholesterol, fibrous tissue and calcium. This is called by different terms: atherosclerosis or arteriosclerosis or “hardening of the arteries.” As the arteries become narrower, the heart has to work harder and vital organs can become starved of oxygen and nutrients. `The result of reduced blood flow to organs are heart disease, gangrene to the feet, stroke, memory loss and death.
The cells of the blood vessels are damaged by “free radicals.” These are particles that come from metals like iron, mercury, lead and many others. Instead of having a neutral charge, where there are as many positive charges as negative charges, they have lost or gained a negative charge. In order to once again become neutral they take a negative charge from another molecule, thus starting a cascade of unpaired ions. Free radicals are like microscopic bullets constantly hitting the cells. This damage causes the cell walls to become leaky, allowing sodium and calcium to enter and accumulate, resulting in blockage and spasms of the arteries. In other words, free radicals can give rise to plaque or/and cause the arteries to go into spasm, either way diminishing the blood supply—and therefore nutrition—to the tissue.
Surgical intervention—by-pass surgery and stents—is invasive and can have deleterious side effects. The cure rate is often brief, because these interventions treat only a few vessels, whereas the blood vessel damage is likely to be widespread throughout the body. Recovery is usually lengthy and supported by numerous medications.
Chelation uses a synthetic amino acid (EDTA: Etheylene Diamine Tetra Acidic Acid). Introduced into the vein, it flows throughout the blood stream and bonds at the molecular level with the metals and minerals that are a major cause of arteriosclerosis. The EDTA, together with the heavy metals and minerals with which it has bonded, is eliminated through the kidneys within twenty-four hours. Passing through all the vessels of the body it removes toxic oxidative metals (lead, mercury, cadmium), and normalizes essential metals if they are in excess (since even excess of the necessary elements can be toxic). As EDTA removes metal irritants, the leaky and damaged cell walls are able to heal. This leads to reduction of plaque, more pliable arterial walls and therefore better blood flow.
More than 400,000 patients have received more than 4 million chelation treatments over the past thirty years. Not one death has been directly attributed to chelation therapy, which allows patients to avoid the trauma of surgical intervention for cardiovascular disease, diabetic arterial disease, and leg pain (intermittent claudication).
Unlike surgical interventions, the office procedure of chelation therapy improves the entire vascular system’s blood flow. Chelation is also a non-invasive process that can intermittently be done to prevent recurrence. Chelation can also be used in conjunction with other cardiovascular therapies and medications. Accredited chelation physicians stress the importance of exercise and nutrition to get the best results from chelation treatment.
Unfortunately, although chelation therapy is approved by the US Food and Drug Administration for use in treating lead poisoning and toxicity from other heavy metals, it has not yet received FDA approval for the treatment of coronary artery disease. In the conservative environment of conventional medicine chelation therapy is still considered to be experimental and the cost is not covered by insurance. The National Institute of Health has recently allotted $30,000,000 to explore the benefits of this relatively low cost but highly beneficial procedure. Also, the New England Journal of Medicine had some positive articles on chelation in the January 2003 issue.
Chelation therapy is an office procedure for a fraction of the cost and trauma of bypass surgery or stents. A usual course of treatment is between twenty to forty sessions, with a total cost of $2000-$4000. This can be compared with $45,000-$65,000 for a surgical intervention.
For those thinking of participating in chelation there are a number of books that will shed light on this treatment:
- Forty Something Forever by Harold and Arline Brecher
- Chelation Therapy by Dr. Morton Walker and Dr. Hitendra Shah
- Bypassing Bypass by Elmer Cranton MD
Or for both sides of the debate search for chelation therapy on the web.
Hydrogen peroxide for virus infections and certain cancers Glutathione therapy: especially helpful for people with any liver problems since glutathione is the most abundant and necessary anti-oxidant in the body and is produced by the liver.
Colloidal silver therapy: this well-established and proven therapy kills bacteria, yeast and viruses. It is fast acting against viruses and upper respiratory problems and can be used in conjunction with hydrogen peroxide.
Ion Cleanse Foot Bath
This is another way to eliminate the toxins that we absorb from the environment (pesticides, herbicides, building materials, heavy metals, medicines) and those produced by stress. It works by an ionization mechanism that pulls toxins from the body without being invasive. I also add colloidal silver by mouth. The ionization causes the release of microbes from the organs and the circulating colloidal silver in the blood kills these as they emerge.
Exercise and Nutrition Counseling.
I have been an athlete for more then fifty years and have a special interest in both exercise and nutrition. In exercising for health and energy, or in more serious sports training, it is impossible to separate nutrition and exercise. You can work out religiously but if you are not eating wisely the full health benefit is not reached, because the body is not receiving the nutrients it needs in order to build healthy tissue. By the same token, if you eat healthy foods but do not exercise the health benefits are diminished. Muscle has to work to maintain or increase its mass.
After years of abuse, both poor nutrition and lack of exercise can have chronic consequences on the body. This is especially true if proper nutrition has not been followed for long periods of time while the body was under physical stress, such as intense sports training.
Exercise
I do believe that both aerobic exercise and resistance (weight) training are necessary to keep a healthy body. The resistance is necessary to build strong muscles and bones and to prevent osteoporosis; the aerobic for cardiovascular health. I have long experience in both and share my ideas and experience with patients. I find this helpful because many people are either afraid of starting or have no idea of how to start. Stretching both before and after exercise keeps the muscles toned and helps prevent injury.
Exercise does not have to be either strenuous or boring. Today there are many different types from which to choose. Some people would benefit from joining a gym so that the exercise is structured, the equipment is there, instructors are available, and the possibility of a social atmosphere is present. There are numerous classes offered in different forms of exercise. Other people prefer to exercise at home, using their own equipment and/or videos. It can be beneficial to have an exercise partner so that you can keep each other’s motivation high as well as having time to enjoy each other’s company. The type of exercise that works for you is the one you enjoy.
Nutrition
The father of western medicine, Hippocrates, said: “Let your food be your medicine and let medicine be your food.” Good nutrition provides the building blocks the body needs to create healthy bone and tissue, and helps not only cure ailments but prevent future ailments. (For example, nutrition plays an enormous role in cancer prevention and cure.) And of course it is possible to have good nourishment and at the same time enjoyable foods. The days of “health food” that was without color or taste are long gone. It is also possible to age without growing old.
Each individual is unique. Therefore, no one diet can fit everyone and it is the task of the physician and the patient working together to figure out an ideal eating program. There are four premises for good nutrition: nutritious non-toxic foods (often referred to as whole foods of live foods), digestion, absorption and elimination.
Nutritious, non-toxic foods: An appropriate balance of protein, complex carbohydrates, healthy fats and plenty of water is the foundation of a healthy eating program, utilizing foods that are produced without artificial hormones or pesticides. Processed refined foods (referred to in holistic circles as the Standard American Diet or SAD) do not provide the vitamins and trace minerals that the body needs to form enzymes, hormones and building blocks to rejuvenate the body.
Digestion: This is the process by which food is broken down into a form which can be used by the body. Maldigestion due to inadequate digestive enzymes can lead to the discomfort of indigestion and other diseases.
Absorption: It is often said that we are what we eat. It would be more accurate to say that we are what we absorb. If something is interfering with the absorption of nutrients, even if we are following a healthy diet and taking supplements we do not derive the full benefit from them. The healthy natural food and the expensive supplements simply pass through the system and are eliminated. Malabsorption can be due to dysbiosis, (when the small intestine has an overgrowth of pathological flora), or leaky gut syndrome, (when the small intestine lets through its wall molecules that it should not, and blocks the molecules that it needs). Also to be considered is the common possibility of having intestinal candidiasis (an overgrowth of yeast in the intestine). This often happens when a person has been on antibiotics or steroids, even if the event was years before the yeast flourished and manifested symptoms.
Elimination: Poor elimination is often the cause or result of unhappiness and intestinal pathology. Both constipation and loose bowel movements can be caused by not taking in the right foods and/or taking in the wrong foods. Either way these can lead to dysbiosis, leaky gut syndrome and malnourishment.
Poor nutrition: Poor nutrition can result from some allergies or intolerance to certain foods, such as dairy. The physician must also consider celiac disease, which leads to an intolerance for products containing gluten (such as wheat, rye, oats and barley.) Certain “food myths” should be discussed, for example “all fat is bad for you.” Certain fats, such as the omega 3 fatty acids, are essential to our well-being.
Nutritional counseling: Nutritional counseling for weight loss, muscle enhancement, disease cure and prevention, involves a personal and family history and identification of the client’s goals and the best way to achieve them. Fortunately, most problems can be corrected and one can age gracefully.
I have participated in, and been injured in, many different sports. And during my thirty years of medical experience I have worked with many athletes and dancers. Many dancers, perhaps even most, have at some point in their careers been told by a traditional physician that they would never dance again. Many athletes have heard that their days of participating in sports are over.
I believe there are always ways of working back into exercise and therefore participating (sometimes with modification) in activities that we enjoy. Knees, shoulders, and backs can be managed most often without surgical intervention. There are many options to be explored before resorting to what should be the last resort of surgery.
Chronic Diseases, Degenerative Diseases, Anti-aging.
Conventional medicine can be close to miraculous in dealing with acute illnesses, but it seems to fall short when problems are chronic. Integrative medicine seeks not only to cure the origin of illness, but also to hinder the advancement of dis-ease. We use mostly botanicals, supplements and alternative treatments to do this so that we do not create harmful side effects. We work with the individual to create a wellness program specific to their needs.
Chronic arthralgias, cardiac problems, pain management, repetitive urinary tract problems, memory loss, hormone replacement therapy for men and women and promotion of general good health are some examples of what can be helped with non-toxic intervention. We try to keep diagnostic tests to a minimum and work mostly by listening to the patient and using our six senses.
Hormone Replacement Therapy for both men and women is a proven anti-aging alternative. Many women have either too much estrogen compared to progesterone and/or too little testosterone. Men may also have too much estrogen compared to progesterone, and testosterone in men is critical to anti-aging in mind and body.
Testosterone is not only necessary for the gonads. It is necessary for both men and women. Research has proven that the most receptors for testosterone are n the heart muscle, and cardiologists throughout the world, including the US (since a lot of the research was done at Columbia’s Physician and Surgeon Institute) are using testosterone in the treatment of cardio pathologies. Testosterone also promotes the body’s own natural nitroglycerin, known as nitric oxide. Functional MRI (fMRI) testing has shown that testosterone is necessary for clear thinking and helps stop the “foggy brain” that often comes with aging. There is new evidence that testosterone may be a preventive factor in Alzheimer’s Disease and even slow down its progress in those who already have it. Testosterone has an anti-depressive effect, and is a key factor in the prevention and cure of osteoporosis.
Testing for these hormones will lead to the appropriate combination. Other life style changes and botanicals are explored to improve cognitive functions. There are many ways to age gracefully without growing old.
There was a time when people married in their early teens; women bore children almost yearly; men were experienced warriors by the age of 16; and forty was considered to be advanced old age.
We now benefit from better nutrition and health care, and the average life expectancy is in the late seventies. However, we have been led to believe that in our later years we have to live with a certain loss of functioning and quality of life.
Both women and men as they grow older produce less estrogen and testosterone. Some of the effects of this can be anxiety, irritability, fatigue, loss of energy, poor focus, poor concentration, depression, loss of muscle tone, osteoporosis and loss of sexual desire. Women may experience hot flashes and night sweats. Men may experience decreased erectile function and prostate enlargement. Both sexes may experience weight gain, even in spite of exercise, or no improvement with exercise.
The highly publicized Women’s Health Initiative study was designed to measure the effects of hormone replacement therapy (HRT) on the above symptoms in women . It was discontinued in August 2002 because of increasing rates of breast cancer and cardiovascular disease, an event that caused shock waves throughout the medical community and among women. This study, however, was using synthetic patented estrogen derived from horse urine, a hormone that on the molecular level does not have the same structure as the estrogen produced in the human body. It is self-evident that such a substance will not be well tolerated by the body, and will place undue stress on the liver as it attempts to process it.
Fortunately, there is a bio-identical hormone—i.e. a hormone with the exact molecular structure of that produced by the human ovaries and testes—that has been in widespread use in Europe since 1936 and has been available in the US since 1939. This kind of hormone therapy has had continual positive research papers published in respected international medical journals from 1936 to the present day. It is not widely known in this country because it is a natural product that cannot be patented, and is therefore of little interest to the pharmaceutical companies that engage in aggressive marketing of synthetic hormones.
The various delivery systems of synthetic hormones all have drawbacks that contribute to uncomfortable side effects. Synthetic hormones taken in pill form have to be processed by the liver, and larger doses are required to compensate for the part of the drug that the liver eliminates. Patches have adhesive problems. Hormone shots are absorbed in an irregular fashion and with long term use create increased resistance, necessitating higher doses. Levels of the hormone fluctuate throughout the day, giving a roller coaster effect of feeling better at certain times of day than others, instead of being in steady supply or adjusting to the body’s changing requirements. Gels, creams and pills may have to be taken twice a day to try and even out the roller coaster effect, which is a hassle. All are delivering a hormone that is often not bio-identical to the human hormone.
Hormone pellet therapy provides hormones that are biologically identical to those produced by the human body. They are administered in a form that is directly absorbed into the bloodstream and provides the hormones when and in the amounts that the body needs, just as the ovaries and testes do. Tiny pellets, about the size of a grain of rice, of estradiol and/or testosterone are placed under the skin in the fatty tissue. The active area of hormone delivery is the outer surface of the pellet. A small percentage of the surface area is released into the blood stream twenty-four hours a day, and the effects of treatment last for four to six months. This method of delivery allows the body to take as much or as little of the hormone as it requires. If you exercise strenuously, or are under stress, the increase in heart rate and muscle activity will generate a faster release of hormone from the surface area of the pellet, because the blood is flowing more rapidly. When the exercise or stress is over, the body returns to its normal heart rate and the level of hormone release from the pellet returns to its base rate.
Introduction of the pellet into the fatty tissue of the buttock is a simple procedure that takes only a few minutes. The area is numbed with a small amount of Lidocaine, similar to the numbing effect experienced during a visit to the dentist. The pellets are placed under the skin via a needle instrument inserted into the fatty tissue. There may be some discomfort for a few days, though many patients experience no discomfort at all. Many patients report noticeable benefits within 3 days to 3 weeks.
For further information on hormone pellet therapy you can visit the web site of Gino Tutera, MD, by clicking here: www.natureshormone.com
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