The Integrative Approach to Women’s Health

The Integrative Approach to Women’s Health

May 10, 2007

The road to health begins in the same place for everybody. This place is the beginning, it is our core. It is the basis of each of our lives. For optimal health we need to do all these basic things as well as we can and limit the stress and destructive aspect.

We need to eat healthfully, and exercise regularly. In the workplace we need to make sure that we are productive and gratified with what we do. For me, this is my second career. My first was as a traditional pharmacist owning a traditional pharmacy early in the 80’s. At that time people bought perfume, and other cosmetics from the local pharmacy. I sold Guerlain and Chanel fragrances and cosmetics as well as filled prescriptions. In 1982 my life and my career received a rude awakening to a disease called AIDS. Being in the East Village at the beginning of this epidemic changed my course immediately. As the disease spread I realized that I couldn’t just stand by filling prescriptions that were as deadly as the disease itself. I started then on my path to integrate healthy alternatives into my life and the lives of my patients. I learned the importance of a healthy diet from watching my patients dwindle away from the ravages of HIV and the host of other diseases that accompanied a compromised immune system. When I read their blood work it showed many signs of deficiencies. When my anemic patients tried some B12 they felt better. Even a plain multivitamin made a difference in energy and health. I found that HIV in women was not as well understood as in men because much of the research was only done in men. By the early 90’s my pharmacy was out of the perfume business and into the natural health business. In 1999 I sold my East Village pharmacy and proceeded to open my new integrative pharmacy combining the benefits of nutrition, exercise, proper diet and supplements to take a more proactive approach to health and disease prevention which is basically not part of the “ Modern American Medical Paradigm “. In addition I built two laboratories, a sterile “clean room” for preparing injections and IV’s., and a non-sterile compounding laboratory. My pharmacy is principally a compounding laboratory where we can address issues without currently available medicines. It uses the principles of integrative medicine combining the natural with the pharmaceutical, when necessary.

Along this journey I learned of a new therapy being used in men and women called Bioidentical Hormone Replacement Therapy or BHRT. For many years I had dispensed synthetic hormones to my female patients going through menopause and always had reservations about the use of a horse extract in women. Needless to say, this started me on a different path. This one led me to the whole field of women’s health.

A well rounded approach to health must always start with our basic needs. We were designed to move, lift, work, and do physical things with our bodies. It was not God’s intention for us to sit in front of a computer screen or television for hours at a time. As technology has advanced, the physical things we do have become less and less. This process began with the Industrial Revolution and is still advancing. Many of us have realized that the lack of movement is affecting every part of us from your head down to your feet. This is not a new concept and so the memberships in gyms, yoga studios, and other places of fitness, have grown. What we fail to understand is that three or four hours in the gym or dojo, or anywhere else, does not replace the forty or more hours of menial labor that our ancestors performed each week.

Whether a person exercises or not, we must consume the appropriate diet based on our individual needs. Always keep in mind the old premise “Calories in, calories out “. If you don’t want to store excess calories than you have to use them or consume less of them. Each woman needs to start this health journey with a plan in mind. I often have women keep a food journal for several days to be able to assess if they are meeting their nutritional needs. I like a well rounded diet, combining three meals, at least two healthy snacks and a diverse assortment of fruits and vegetables. The exact combination varies according to need. The more muscular a person is, the greater their protein requirement. So a healthy diet would combine the proper balance of all the main “Macronutrients“, protein, complex carbohydrates and healthy fats. This balance may be different for every woman because every woman has their own individual needs and nutritional requirements.

We need to put more steps in our day. Do more physical things and with that enjoy the outdoors. Walking on the treadmill is great when it is freezing outside but nothing replaces fresh air and sunshine. Most people require at least four hours of exercise a week but there is no established maximum. When starting to make lifestyle changes it may be easier and safer to make them gradually. Of course, if there are any health issues than a qualified practitioner should be consulted to define your limitations. If you have never exercised than start by walking 5 or 10 minutes a day, three or four times a week, slowly increasing the pace and the distance as your body becomes more accustomed to it. Try parking a little further away from your destinations and take the stairs instead of the elevator when practical. Putting more steps in your day is the easiest way to increase calorie consumption and start the path to exercising your mind, body, and spirit.

The questions surrounding supplements continue to grow and though knowledge and understanding have also grown, pharmaceutical companies continue to hamper this quest by spending more and more money on their own studies and funding lobbyists that try to hamper our pursuit of a more natural approach to health. There is no doubt that the drugs we have developed are saving lives but they could save many more lives if they were part of an integrative lifestyle combining a healthy balance of diet, exercise, necessary supplements, and when these fail, pharmaceutical medications.

In integrative medicine we speak about the “core” nutrients. These are the vitamins and minerals that we all require. I generally start people on a Multivitamin and mineral complex first. There are many out there so selecting an appropriate combination is not that difficult. Some of the new age-targeted formulas combine most of a person’s needs into one formula for ease of use. So a women’s formula for women over forty will include more calcium, magnesium and trace minerals than a formula designed for younger women. This simplifies what a person needs and often taking fewer products increases compliance. The next core nutrient necessary is a good healthy source of Essential Fatty Acids, also known as EFA’s. EFA’s are essential because we cannot make them. We need to ingest them so that our bodies can then use them as raw materials for other things we do make. These include cholesterol (much needed), hormones, prostaglandins (messengers that help us control all sorts of processes in the body, including inflammation). There are so many problems with the environment and this includes our water. Eating fish that is not contaminated has become a problem and there is nothing in the literature that leads me to believe that things will change any time soon. Keeping your “ toxic burden “ low is the only thing we can control in trying to prevent cancer and other autoimmune diseases that seem to be growing in numbers in spite of all the new “ scientific advances”. In order to get the omega 3’s that you can get from one or two capsules of oil a day, you would probably need to eat 4 to 6 servings of fish a week, and thereby risk exposure to elevated levels of mercury, arsenic, cadmium, and lead. If you ate farm raised fish, than you increase your risk of exposure to dioxins ( carcinogens ) and PCB’s ( also carcinogens ). The amount of fish oil a person should take also varies according to need.

The next core nutrient is a Probiotics. This is what many people commonly refer to as “acidophilus” but in reality is a whole family of beneficial bacteria that is comprised of many different “friendly” bacteria that thrive throughout the gastrointestinal tract, starting in the mouth and ending in the rectum. For women without any serious or chronic gut issues, eating a good organic yogurt containing live cultures of friendly bacteria, on a regular basis, is adequate.

For women, the big question today is about Calcium. While we have all become conscious of our need for calcium many people are unaware of the need for magnesium, adequate amounts of vitamin D and the need for other trace minerals that aid in absorption. The amount of minerals that are needed varies from person to person. Women after the age of forty should begin to get bone density studies done to assess their need for minerals. The average woman needs 1000mg of calcium a day, 400 to 800mg of magnesium a day, and at least 800 to 1000 units of vitamin D3. If the bone density test, also called a Dexa scan, shows osteopenia or the beginnings of osteoporosis than I increase the calcium to 1200 to 1500mgs a day and increase the magnesium accordingly. I often request that patients have their vitamin D levels measured because many people supplementing with calcium and magnesium are still showing signs of progression of their bone density issues. In our search for answers why, the question of the right amount of D has come to be a new insight into possible failures of other therapies. In osteopenia and osteoarthritis, weight resistance exercise is essential for stopping progression.

There are a million supplements on the market and I encourage all women to try and get as much of their nutrition from food and then target the remaining imbalances with the supplements that are necessary. I encourage all my patients to eat as organically as possible. We need to reduce our exposure to chemicals. As long term studies are limited, I assume that all chemicals are bad and try to reduce them every where possible. Animal protein like chicken, fish, beef, and pork, as well as all dairy carry a heavy burden of toxins with them. First they contain the herbicides and pesticides from the foods they are grown on, and second they are usually given hormones and antibiotics to maximize the yield. All of these are passed to us when we eat these things. I implore all people to buy as much of their foods organically but animal derived products especially. With ovarian and breast cancer on the rise, you have to question the “estrogen dominant “ nature of society due mostly from the consumption of xeno estrogens and phyto estrogens from the food supply. With vegetables and fruits I take an aggressive approach to washing them before I consume them.

Last but not the least is the need for all people to find emotional and spiritual happiness in their lives. It is within this precept that the importance of the mind-body connection becomes most evident. It is important for our health to have healthy love in our lives. Achieving this varies. Yoga may help, support groups, healthy friendships, belief in God and prayer, and meditation are all good things but whatever path you choose, find happiness in how you look for happiness. The journey is as important as the destination.

Human Compounding

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