Wellness Connection MD

Root Causes of Disease

February 27, 2024 James McMinn Episode 42
Wellness Connection MD
Root Causes of Disease
Show Notes Transcript Chapter Markers

Podcast summary

 

In this episode of Wellness Connection MD, Dr. McMinn take  a deep dive into  the root causes of disease and how an understanding of these root causes can be used as a diagnostic and therapeutic tool as a part of a functional medicine approach to a patient.

Think about your own health, or if you are a provider then think about the patient in front of you, then keep asking the question "What is the underlying root cause of the problem."   Then use the list of root causes outlined in this podcast to help you come up with the answers. I call this the "why" approach to medicine. This approach may help you better understand the problem, and thus come up with more effective solutions. 

Along the way, Dr McMinn also provides some insights and practical solutoins pertaining to each of these root causes of diseae. 

At the end he summarizes all of these into the four fundmental causes of disease.  It is where these four factors come together that we see disease emerge. 

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Speaker 1:

Hello, this is Dr McMahon and welcome to Wellness Connection MD. Have you ever wondered what are the root causes of disease? Well, that's what we're going to talk about on the show today. Give you a breakdown of just about all of the causes of disease and if you listen to the end, I'll explain to you how all health problems fall down to four fundamental causes. I hope you enjoy the show.

Speaker 2:

Welcome to the Wellness Connection MD podcast with Dr McMahon and Coach Lindsey, where we bring you the latest up-to-date, evidence-based information on a wide variety of health and wellness topics, along with practical take-home solutions. Dr McMahon is an integrated and functional MD and Lindsey Matthews is a registered nurse and IIN certified health coach. Together, our goal is to help you optimize your health and wellness in mind, body and spirit. To see a list of all of our podcasts, visit wwwmdcom and to stay up to date on the latest topics, be sure to subscribe to our podcast on your favorite podcast player so that you'll be notified when future episodes come out. The discussions continue. These podcasts for educational purposes only and are not intended to diagnose or treat any disease. Please do not apply any of this information without approval from your personal doctor. And now on to the show with Dr McMahon and Coach Lindsey.

Speaker 1:

Hello and welcome to Wellness Connection MD, the evidence-based podcast on all things wellness. We thank you so much for joining us today. I'm Dr Jim McMahon and I'm flying solo today. Coach Lindsey has a much-deserved day off and we'll jolly miss her, but we'll look forward to having her back next time on the show. As always, we come to you to bring you commercial-free, honest, unbiased, up-to-date, evidence-based, outcomes-oriented information, along with practical solutions in order to empower you to overcome your health care concerns and to optimize your wellness in mind, body and spirit, and to become a great captain of your ship when it comes to your health and wellness.

Speaker 1:

If you've been with us for a bit, you're familiar with the term. Functional medicine is defined as a system-spiology approach that focuses on identifying and addressing the root causes of disease. Today's show gets at the heart of the matter and that we're going to be discussing the underlying root causes of disease. It has been an interesting challenge for me over the years to put together this list, and it is something that I actually use on a clinical basis day-to-day when I was seeing patients. When some complicated patient presented to me, I would use this list to uncover what might be the root cause of the patient's problems. Sometimes it's created a breakthrough in the patient's care plan and improved their outcomes. So I'm excited to share this list with you today and hope you enjoy it.

Speaker 1:

Before we get going, we have a couple of brief housekeeping duties to take care of. Our podcast remains commercial-free, so you won't be bothered by those annoying and sometimes disingenuous commercials. However, it does cost us money to produce these podcasts, so think of us like public radio and consider making a contribution to help us keep it coming to you. There are a couple ways you can contribute. First, if you buy nutritional supplements and I'm not asking you to buy anything you don't already buy but if you buy nutritional supplements, then consider purchasing these physician-grade supplements from our full script dispensary at a 10% discount. You can see the link to full script below in the show notes. Or you can go to McMinnMDcom and the link will also appear there at the bottom of the homepage under helpful links. It's quite simple Just click on the link and they'll guide you through the process. It's a win-win you get the high-quality supplements at a discount and we get your support for the show, for which we are very grateful. You can also make a contribution directly to the show via credit card or by PayPal at the support the show link which is in the show notes, and please don't forget to subscribe to the show and please tell your friends and family about us so that we can keep it growing. Thank you so much. And now on to the show.

Speaker 1:

Again, we're going to be discussing the root causes of disease in the context of a functional root cause approach to our health problems. I call functional medicine why medicine? Because we're always asking the question why? Why did the patient get the problem? What's the root cause? When you are a functional medicine doctor, you revert to being a three-year-old. I remember when my kids were about that age and they would always ask daddy, why is the sky blue? Or daddy, why is the moon so bright or whatever. I have to be honest, sometimes the questions challenge me. Even when I did come up with what I thought was a pretty good answer, they would follow up with another why question. The kids were just trying to better understand the world around them, how things worked. Similarly, as a functional medicine doctor, when I go beyond the standard symptom pill medicine approach to more of a functional why medicine approach, then I can better understand what's going on with the patient. Hopefully, this allows me to develop a better treatment plan and to have better outcomes. It even allows me to have success with difficult patients where other what I call regular doctors have failed. Now, before I became a functional medicine doctor, I was on the regular medicine side of the fence for 20 years, both in the emergency room and in academics at various medical schools. So I've seen it from both sides. And let me be clear there's a time and a place for both kinds of medicine. It's not either or both have their place, and the point of this discussion is not to bash regular doctors. On the contrary, I have great respect for them. However, I'm just pointing out that there is another new, exciting way of practicing medicine, called functional medicine, where we're trained to, as Apple says, think different, to peel back the layers of the onion as we get to the root cause of the problem, rather than taking what sometimes to turn out to be a bandaid symptom pill approach.

Speaker 1:

In regular medicine, the emphasis is coming up with the diagnosis and then the doctor's mind immediately turns to treatment, which is usually in the form of drugs or surgery. This is the way that doctors are taught to think what drug can I use to treat this diagnosis. Let's use a real patient example to illustrate this. I will call this patient Mrs Jane Doe. She came to see me with a main complaint of diarrhea. She had already been seen and worked up for the diarrhea and was found to have C diff colitis. C diff is an infectious colitis that often comes about after the use of antibiotics. These infections can actually be quite severe, difficult to treat and in some cases even deadly. The classic treatment for this is to give even more and different antibiotics. So in this case, the doctors did what they were trained to do they came up with the diagnosis and they treated her with drugs.

Speaker 1:

But what I want to focus on is the why of the matter. That's the premier question in functional medicine that we always come back to why did the patient get the problem I E? What are the underlying root causes? So in Mrs Doe's case, let's put on our functional medicine hat for a moment and then ask the question, just like a three-year-old why did the patient come see me? She has chronic diarrhea. Why does she have diarrhea? She has C diff colitis. Then why does she have C diff colitis?

Speaker 1:

Because she has been on chronic antibiotic therapy. But why was she on chronic antibiotic therapy? Because she had chronic UTIs, urinary tract infections. Now, let's keep going. Why does she have chronic urinary tract infections? Because she had poor vaginal health in the form of dryness and atrophy, which made her much more prone to UTIs. But don't stop there, let's keep going. Why did she have poor vaginal health? Because she had almost no hormones on board. Why did she have low hormones? Well, that can vary from woman to woman, but in Mrs Doe's case she had outlived her ovaries, ie she went through menopause. For some women it could be something like a hysterectomy. And finally, why did she go through menopause? Because of the aging process and here's the kicker to me and because she did not have a doctor who believed in bioidentical hormone replacement therapy. If Mrs Doe had taken bioidentical hormone replacement therapy properly, then she would not have had the dryness or atrophy, would not have had the UTIs, would not have taken the chronic antibiotics and would not have acquired seed of colitis and the resulting diarrhea. So in this case, as in many cases, peeling back the layers of the onion step by step and connecting the dots allows us to get to the root cause of her problem.

Speaker 1:

In some cases you can treat the root cause and prevent further damage. In other cases the damage has already been done due to ignoring the root cause for many years. So, for instance, ignoring cardiometabolic dysfunction may result in a stroke. So if you treat cardiometabolic dysfunction early in the process, then you may be able to prevent the stroke. However, once the stroke has happened, then it's obviously too late. You've already missed your window of opportunity and you can't do a take two on this. In Mrs Doe's case it was too late to take away the damage that was done due to the lack of attention to her initial concerns. But we did do our best to help her with the diarrhea and certainly we made some progress there for her.

Speaker 1:

Please allow me just to take a couple of seconds to do a mini rant about vaginal rise in naturopathy. These are problems that affect women's lives in many ways and for the most part they are entirely preventable with a proper front-end preventive care treatment plan. As I've said on other podcasts, the medical community shamefully ignores women's vaginal health. If men's penises were undergoing atrophy like women's vaginas, we would declare a national emergency, call-out to the National Guard and pour millions of dollars into finding a cure. I'm just saying Okay, I'm done ranting. However, you want to learn more about this, then check out my podcast number 27, which is about vaginal dryness. So now, without further ado, let's dig into our list of causes of disease, with a few comments about age along the way. These are listed in no particular order. At the end, we're going to tie it all together with an interesting concept and I'm going to summarize for you what I think are the four fundamental root causes of just about every disease.

Speaker 1:

Let's start with genetics and epigenetics. Genetics can play a major role in health and disease. It goes without saying that if you are born with a major genetic problem, then that can affect if you live and how well you live and how long you live. However, epigenetics also plays a major role. Let me take just a minute to briefly explain to you the difference between genetics and epigenetics. Genetics has to do with the actual genetic code that you are born with. However, epigenetics has more to do with gene expression.

Speaker 1:

Genes can be turned on or off like a switch. For instance, two identical twin females may have the exact same genetic risk for breast cancer. However, one may get it and one may not. Why is that? Well, for one woman, the genes lie dormant and for the other they got switched into the on position. The main factors that turn genes on or off are things like diet, physical activity, toxins, stress, working night shifts, obesity, just to name a few. For instance, the twin who becomes obese has a much greater chance of that gene for breast cancer getting turned on than her normal weight twin. Another interesting factor that changes epigenetic expression is intrauterine exposure. For instance, if mom was mega stressed out or ate a terrible diet or was exposed to toxins during pregnancy, then this can affect the epigenetic expression of the offspring, resulting in real disease. In his wonderful book the Biology of Belief, dr Bruce Lipton, phd cell biologist, describes the genetic code as just what I call a dumb blueprint. It really doesn't make any active decisions about your health. It is the epigenome that really controls expression of genes. So you may not have control over the genes that you were handed down. However, you have major control over how those genes are expressed via your epigenome by optimizing your basic life habits such as diet, sleep, stress, toxins and movement. For more information about lifestyle medicine, please check our podcast number 34.

Speaker 1:

The next cause of disease that we'll discuss is iatrogenic, which is what happens when health problems are caused by medical errors or unwanted complications of what are thought to be proper medical treatment, such as, for instance, an allergy to drugs. It may be the proper treatment, but that particular patient just has a terrible allergy and can end up with some badness due to that. An example would be surgery complications Like nicking an artery or post-op sepsis. Diagnostic procedures like colonoscopies can also cause problems. A recent article in the National Institutes of Health, published in 2017, estimated that medical errors account for as many as 251,000 deaths in the US annually, making medical errors the third leading cause of death. Wow, that's kind of scary and, to be clear, we're talking about death here and this statistic does not reflect the non-fatal problems, some of which, although can be quite severe, that come from iatrogenic causes.

Speaker 1:

For example, the experts tell us older folks to get regular colonoscopies. However, about 1.6% of colonoscopies result in complications, and the list of potential complications includes death, as well as some other serious problems. Now, that sounds like a fairly low number at 1.6%, but let's crunch some numbers. In the US, about 15 million people get colonoscopy each year. So 1.6% of 15 million people comes to about 240,000 people who run into iatrogenic problems due to colonoscopy each year, so it becomes a big deal if you or your loved one happens to be one of those people. So, at the end of the day, each doctor and patient has to do what they call a risk-benefit analysis to make the decision as to whether that scope is going to benefit them or not. It's worth noting that in a recent study in 2022 published in the New England Journal of Medicine, they found that colonoscopies do reduce the rate of getting cancer, however, not as much as they previously thought, but they also found that colonoscopies do not reduce the risk of death from colorectal cancer.

Speaker 1:

So let me be clear. I'm not saying to do scope or not to do scope. I'm just using this as an example of a seemingly benign diagnostic screening procedure that can have major or even fatal iatrogenic complications. One thing I learned early on as a medical student was to never, ever, take surgery lightly. I've seen young people die from complications from surgery. Simple surgery Stuff happens in the OR that we cannot predict, even under the best of circumstances. Again, to be clear I'm not anti-surgery. It's a miracle of modern medicine and it saves countless lives every day. In fact, it saved my life years ago, and so I'm just saying there's always a risk involved that must be considered and mitigated, and we have to do that risk-benefit analysis.

Speaker 1:

And now let's move on to our next cause, which is sedentary lifestyle. In Dr Peter Adia's new book called Outlive, he points out that exercise is the number one factor that results in improved health span. By the way, let's differentiate health span from lifespan. Lifespan has to do with how many years you live, whereas health span is all about how long you are healthy. Interestingly, there is sort of a Goldilocks sweet spot when it comes to exercise Too little is bad for you and too much is bad for you. Over exercises have an increased morbidity and mortality. That means they get more health problems and they die younger. The negative health consequences of a sedentary lifestyle requires a whole podcast onto its own, so I won't go into it in great detail, but just to summarize that this is a huge issue for overall health. Fish got to swim, birds got to fly and people got to move. If we stop moving, the game's over.

Speaker 1:

Next we'll talk about aging. As I journeyed through my 20 years on the front lines in the emergency room, there were a few what are called Macminisms that came about. One of them was that bad things happen to old people. The reason I always kind of kept that in my mind was when an old person came in with a problem, you always have to give it a more thorough look because it was more likely that it was due to some really bad underlying condition. You just didn't want to miss it. Now I must admit that in my retirement I have entered that old person category myself and I could feel that I'm not as surprised as I used to be. But the bottom line is that as we age we can expect more badness of various sorts to visit us.

Speaker 1:

However, there's an interesting concept of chronological age versus physiologic age. Chronological age is measured how many years you've been alive, but physiologic age is a reflection of the structure and processes of the body's tissues, organs and systems over time. I've known some 70-year-old people who seem to be fitter and healthier than some 25-year-old people, and there are a lot of other factors that lead to that equation. Certainly, for most of us, the fundamentals of how you live your life, ie lifestyle medicine, can play a major role in your health span curve. So bottom line, you can't control your chronological age, but you have major control of your physiologic age by paying attention to the fundamentals of lifestyle medicine, and for more about that, just check out our podcast number 34, where we go into that in great detail.

Speaker 1:

Now let's move on to gut dysfunction, and subsets of this topic would include things like diet, digestion, motility, gut microbiome, intestinal permeability, which is also known as leaky gut, and things like food sensitivities and parasites and all that kind of stuff. There's an old saying that I think holds some truth, which goes like this good health starts in the gut. There's also a gut everything connection gut brain connection, gut bone connection, gut immune connection, gut skin connection, gut hormones, gut everything you name it. Every cell in the body is dependent on the gut to get the nutrients that it needs to be healthy. Therefore, no organ or cell is healthy if the gut is not healthy. We did an entire gut health series, so I won't go into this any further on this podcast, but to learn more about this, check out our podcast number three through seven.

Speaker 1:

The next topic is nutrition. There are a couple ways you can think about this. First would be an actual nutritional deficiency, for instance, scurvy, which the old time sailors used to get because of lack of vitamin C. This list goes on and on. Diseases caused by lack of certain nutrients. Another factor is just poor nutrition, such as in the context of a processed food-laden diet, which the studies have shown contribute to obesity, diabetes, high blood pressure, heart disease, strokes, cancer, early death and more. Foods also have a direct effect on your epigenetic expression that we discussed earlier. Foods are not just calories. They are genetic information for your cells. We already did a podcast on nutrition, so check that out if you wish to learn more about this important topic. It's podcast number 10.

Speaker 1:

So let's turn now to stress. It has been estimated that 75 to 90% of visits to primary care doctors are in some way related to stress. Wow, that's huge. Sounds like we need to chill out as a society, like with exercise. There's a sweet spot with stress, and this may be different for each person. Some stress in your life may be good for you, but too much stress can be disastrous. Again, stress is a major trigger for the epigenome. Too much stress is associated with many diseases, such as gut problems, anxiety, headaches, insomnia, high blood pressure, obesity, depression, heart disease, skin problems, low libido, drug and alcohol misuse, brain fog, fatigue, diabetes, accelerated aging, cognitive decline and premature death, just to name a few. We did a dedicated podcast on stress, which is number 11, so if you want to learn more about this, then just go back and check out that podcast. However, let me say I've always felt it was a cop out for doctors just to say well, you're stressed out, go home and reduce stress. We need to tell people how to reduce stress. So I put together the McMinn Stress Plan and the McMinn Stress Management Toolbox for you, which you can find at McMinnMDcom in the Documents section. You might want to check those out.

Speaker 1:

And now let's move on to sleep. This is another biggie. This includes good old insomnia, as well as other concerns like night shift work or swing shift work, rim sleep disorder and just being out of sync with circadian rhythms, like those folks who want to stay up all night and then sleep until noon the next day. I have a confession to make. When I was a young man, I thought that sleep was a waste of time and I tried to cheat sleep and get as little as possible so that I could, overall, be more productive. On the surface of it, I seemed to survive okay, but I did recall at one point when I was working a lot of night shifts in the ER. I finally realized that the loss of sleep was taking a toll on me and I was taking years off my life. That's when I decided to make a change.

Speaker 1:

The list of diseases that emerge from sleep disorder is lengthy. It especially includes a lot of neurodegenerative diseases, including Parkinson's disease and Alzheimer's disease. I call sleep the magic elixir because it can help so many things. Proper sleep hygiene is the key for most of us, but the bottom line is to place a super high priority on getting restorative sleep. It is hugely important for your overall health. My motto when it comes to sleep is whatever it takes, it's just that important. We did a podcast on sleep, which is number 14, so you might want to go back and take a listen to that if you'd like to learn more about sleep. I also have a couple of documents on the subject at McMinnMDcom under the document section called McMinn Sleep, therapeutic Options and Sleep Hygiene.

Speaker 1:

The next root cause of disease that we'll talk about is social isolation, another underestimated cause of morbidity and mortality. An article from Harvard Health states that people who are lonely or feel isolated have an increased risk of many chronic diseases, cognitive decline, an inability to perform daily tasks and even premature death all just from social isolation. Unfortunately, in our modern day society, people are on the move, families are fragmented, so about 50% of Americans report being lonely. So do what you can to stay connected. Also, reach out to your neighbors, friends, family and those in need to keep everyone in the loop.

Speaker 1:

Moving on now to infections, these include bacterial, viral fungal parasites and infections such as Lyme disease. Often these infections are obvious, and sometimes even deadly, or they can also be a cult, such as a smoldering infection in the urine, sinuses, gums or an endocarditis of the heart. These two can create many problems. Another serious and underestimated problem is the emergence of resistance to many of our previously tried and true antibiotics. Much of this comes from the overuse of these antibiotics in humans and in animals. Patients used to call me all the time saying Dr, I got the sniffles. Can you call me in a Z-PAC? We hand out Z-PACs like they were candy and the bugs are getting smart to these drugs. I'll never forget the infectious disease expert who once said that the road to hell is paved with Z-PACs, and I think he was right.

Speaker 1:

Our next cause of disease is alterations in the microbiome. Recognition of the microbiome as a major player in health and disease has been one of the most exciting developments in medicine in the last 10 to 20 years. The human microbiome consists of about 100 trillion microbial cells, as well as about a thousand different species. We can really no longer think of the human being as just made up of human cells. We are really a what I call a super organism made up of many types of cells, including human cells, but also microbial cells, and the microbial cells far outnumber the human cells and they're absolutely necessary for life as we know it. These bugs help us in many ways, including digestion. They help to destroy harmful bacteria and they are fundamental for the health of the immune system. And when we get unwanted alterations of the microbiome, such as with the C diff infection, as I discussed earlier, this can wreak havoc on our health, even causing death. In and on our bodies we have a skin microbiome, sinus microbiome, oral microbiome, gut microbiome and genital microbiome. New frontiers in microbiome science are also looking at eye microbiome, uterine microbiome, brain microbiome and other areas of the body that in the past were thought to be sterile. This is truly an exciting and cutting edge area of scientific discovery.

Speaker 1:

We tend to take our microbiome for granted. We wash our skin with antibacterial soaps which destroy our skin microbiome. We rinse our mouth with antibacterial mouthwash which destroys our oral microbiome. We take way more broad spectrum antibiotics than we should, which wipes out our gut microbiome. We can take that Cipro for UTI, for instance. It's like a bomb going off in your microbiome. It may take a long time to recover and some experts say that your gut never fully recovers. We did an entire podcast on the gut microbiome, which is the podcast number five. So if you want to learn more about that, I encourage you to go check that one out. We also did a podcast on the vaginal microbiome, which is number 28. So also there for your listening pleasure.

Speaker 1:

Moving on now to systemic inflammation, another huge cause of disease. Inflammation is actually a protective response by your body's immune system against harmful insults like pathogens or other irritants. Unfortunately, with chronic inflammation, the insult is long gone, but but the inflammatory response persists. This lingering inflammation contributes to disease by disrupting normal tissue function and promoting tissue damage. Symptoms of chronic inflammation can vary widely. It may be hard to measure inflammation, but labs like C-rate protein and sedimentation rate and certain cytokines may provide an objective measurement. In some patients. Chronic inflammation has been implicated in many diseases, including autoimmune disease, arthritis, metabolic disease like diabetes, cardiovascular disease and some gut diseases like Crohn's and certain cancers. We did an entire podcast on inflammation, which is number 33.

Speaker 1:

If you'd like to learn more about this, next we'll take a look at immune dysfunction. The classic examples of this are various autoimmune diseases. Some common ones that you may be familiar with would be lupus, psoriasis, rheumatoid arthritis and multiple sclerosis. However, there are really almost a hundred autoimmune diseases that we know of. I recall an interesting analysis on this issue by a Harvard researcher who stated that three things must be present for any autoimmune disease to develop. Number one is a genetic predisposition. That doesn't necessarily mean that mama had the disease, but the genes are hiding in you somewhere. Number two, there needs to be some sort of a trigger that turns the gene on. And third, there has to be some degree of what I call increased intestinal permeability, which we used to call leaky gut. And here we go again with that gut immune connection.

Speaker 1:

Some of the potential triggers of autoimmune disease include food sensitivities, allergies, toxins, infections, poor diet, stress, nervous system imbalance, chronic sleep deprivation, chronic inflammation, trauma, parasites, excessive alcohol, medications, surgery and radiation. There are many new, fancy and expensive drugs on the market these days for autoimmune disease. However, from a functional point of view, I have found that removing triggers and improving the gut function can be powerful healers. I have seen near miracle cures with this approach in some patients. I've not done a podcast on autoimmune disease yet, but I have it on my list In the meantime. My favorite book on the subject is called the Immune System Recovery Plan by Dr Bloom. I'll have that listed for you in the references section of the home page of McMinnMDcom. Dr Bloom does a great job on the subject. You might want to check that out. One word of caution, however, is that when you finish the book you might think, oh my gosh, it's just too complicated. You might feel overwhelmed, but that's when you need to work with your functional medicine provider to customize and simplify the program for you.

Speaker 1:

The next cause of disease that we'll mention is toxins, another underestimated factor. The economic burden from the health effects of toxins is estimated to be about $63 billion annually in the United States alone. Wow, that's just staggering. The various broad categories of toxins that we are exposed to include heavy metals like lead, mercury, arsenic, etc. Organics like pesticides, and then mycotoxins from mold. I was just talking to a friend just the other day and he said he didn't have any significant toxin exposure. My reply to him was that unfortunately, we live in a world full of toxins. They're everywhere. We're all exposed all the time. In fact, we're born with toxins. Studies have demonstrated that organic forever chemicals PCBs, mercury, lead and pesticides and phthalates from plastics have been found in the umbilical cord blood of most babies. Even penguins on the South Pole have elevated levels of mercury. Toxins are in the air we breathe, the food we eat and even in the water we drink. As you know, bottled water is everywhere these days. Studies are unequivocal that bottled water contains significantly more microplastics. These microplastics make their way into the bloodstream and we find them in the blood, the lungs, the breast and even the milk of humans, and they cause many health problems, including metabolic disruption, immune dysfunction, neurodigital disease, chronic inflammation, cardiovascular risk and endocrine and reproductive problems.

Speaker 1:

Another true story I had a patient years ago who came in with debilitating neuropathies. She was miserable. She had seen three neurologists who treated her with drugs, but nothing had helped. As with many of my patients, I was her last hope. Now here is another classic example of what I call regular medicine versus functional medicine. My excellent and I mean that excellent neurologic colleagues did what they were trained to do. They made the diagnosis, which was diffuse neuropathy, and they prescribed drugs to treat it. The functional approach, however, was quite different.

Speaker 1:

I put my thinking cap on and asked why? Why did the patient have the neuropathy? For instance, if you google causes of neuropathy, you'll see a list from Mayo Clinic the Big Shots that clearly states that exposure to toxins, especially heavy metals like lead and mercury, can cause neuropathy. Now here's the disconnect to me. Here we have one of the top medical centers in the world clearly stating that lead and mercury caused neuropathies. Yet three excellent, highly trained neurologists evaluated with this patient and not one of them ever thought about or checked for heavy metals. It's just not on their radar screen. Medical students are not taught about toxins in their training. Why not? I really don't know, but I don't get it. Maybe it's because there's no billion dollar blockbuster drug for it. I'm just saying so anyway.

Speaker 1:

In this patient we did check the heavy metals and she was loaded. We did collision therapy, got the metals down to normal and, poof, the neuropathies went away completely. It was like magic. I was thrilled, and so was the patient. And, by the way, this has been about 10 years ago and the neuropathies have not come back and she's experiencing a great quality of life these days, as opposed to the misery that beset her before our therapy. The proof is always in pudding. It's all about outcomes. In this case, illustrates the power of a why or functional medicine approach. Now we did a whole podcast on toxins, so I won't repeat all the details on this topic. It's a really interesting subject, so if you want to learn more about that, then check out podcast number 22.

Speaker 1:

However, I do think it's worth pointing out here the best defense against toxins is avoidance. So here are some simple tips Get a good water filter. I don't claim to be an expert in this area, but I have done some homework on this and I recommend the Berkey filter. It's a simple carbon block filter dirty water in and pure water out. It's very simple, efficient and cost effective and, for your information, I have no financial interest in Berkey filters.

Speaker 1:

When it comes to food, google the dirty dozen foods and get these particular foods in your organic form. Also, be careful what you put on your body. Toxins and lotions, shampoos, conditioners and makeup go right through your skin and into your bloodstream and into your tissues. So get good quality, clean products. So let me wrap up the toxin issue and leave you with just a few take home points. Number one toxins are everywhere in our modern day world. Number two toxins contribute to many diseases. Number three avoid them when you can. Number four, lastly, when you have some sort of disease, like a patient with neuropathy above, and you're trying to figure out why, at least have toxins on your list of possibilities.

Speaker 1:

Now let's move on to our next cause of disease, which is trauma. There are many types of trauma and they're all important. These would include things like physical trauma, emotional trauma, psychological trauma and sexual trauma. To get more information on the emotional trauma issue, then check out our recent podcast on emotional wellness, which are podcast number 40 and 41. As an old ER doc, I've seen my share of physical trauma and I would urge each of you just to be smart in the way you live your life. Every time I see someone riding a motorcycle, for instance, without a helmet, it's like fingernails on a chalkboard to me as an ER doctor. But that's a values decision that each rider has to make on his or her own.

Speaker 1:

The next cause of disease is obesity. The data are clear that obesity is linked to increased rates of cancer, heart disease, high blood pressure, dementia, cholesterol abnormalities, diabetes, stroke, gallbladder disease and increased all-cause mortality. Obesity and overweightness is a complicated and controversial topic. Perhaps we'll circle back around to that one day and do a dedicated podcast on it, but certainly any discussion about this subject has to at least start with diet and exercise. That certainly counts for a major part of the problem. However, it is admittedly much more complicated than that and it is unfair in some patients to blame their diet when in fact, other factors may play a significant role.

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It's up to the functional provider to rule out some of these other causes. So some of the other contributing factors to obesity might include a hypothyroid state, insulin resistance, metabolic syndrome, neurotransmitter imbalance, fluid retention, systemic inflammation, polycystic ovary syndrome, leptin resistance syndrome, toxins. Many of these toxins are what we call obesity genes and they act through a number of different mechanisms to increase weight. An unhealthy gut microbiome can also contribute to weight. Acetylcarta team deficiencies, stress, lack of sleep being out of sync with circadian rhythms, health nurses tend to weigh more than day-shed nurses. Isn't that interesting? Food intolerance, such as gluten or dairy, artificial sweeteners, drugs such as steroids, occult infections that can cause inflammation, thus leading to weight gain.

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Interestingly, people born by C-section are at higher risk of obesity as an adult. Bottle-fed instead of breast-fed babies tend to have more obesity later in life. Early childhood antibiotics can increase the risk of obesity later in life In utero and early developmental exposure to chemicals such as pesticides and heavy metals, etc. During critical periods of development, even at low doses, can alter programming and can result in increased susceptibility to diseases later in life, including obesity. Common household disinfectants may be linked to childhood obesity. Sleeping with lights on may increase the risk of obesity in women. And finally, genetics may play a major role. According to one expert in the field, there are about 5,000 genes associated with obesity and about 30 hormones associated with obesity.

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So again, the discussion starts with diet and exercise, but in reality it's not that simple. So a general functional approach may be, in order at least to consider some of these other causes that I have mentioned. The next cause of disease that I'll mention is hormone dysregulation. This would include hormones such as estrogen, progesterone, testosterone, thyroid cortisol, dhea, insulin, parathyroid hormone and many more. Neurotransmitter imbalance could be considered to be a subset of this discussion. Hormone optimization and balance are hugely impactful to our overall health and quality of life.

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If there's any concern about your hormones, I would encourage you to work with a provider who has trained and experienced in testing and optimizing hormones, especially with bio-identical hormones. It can make a world of difference in many ways. For instance, let's take the average 50-ish-year-old pyramidopausal woman who comes in feeling miserable. She has no energy, can't sleep, anxiety, low mood, headaches, brain fog, aches all over, irritable emotional vaginal dryness, pain within the course and no libido. With a good bio-identical hormone replacement regimen, all of these problems could become a thing of the past and she could feel fantastic. I'm just saying I've seen it over and over is like magic. So check out podcast number 13 for more in-depth information about hormones.

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Moving on to oxidative stress, this is somewhat hard to describe in layman's terms. However, I'll take a crack at it. It's a condition that appears when your antioxidant levels are low, antioxidants being substances that remove damaging oxidizing chemicals from your body. So when your antioxidants are low, this can contribute to diseases like Parkinson's, alzheimer's, multiple sclerosis, depression, memory loss, cancer, diabetes, hypertension, heartache of the arteries, lung disease and premature aging, just to name a few.

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The best way to combat oxidative stress is with lifestyle medicine, especially diet. The diet should be balanced and within abundance of fruits and vegetables and a limited intake of sugar and processed food. Regular exercise can also be helpful. Supplements should never take the place of diet, but in some situations specific supplements may be helpful. Some of the major antioxidant supplements include vitamin C, vitamin D, vitamin E, coq10, zinc, solenium, glutathione, green tea, resveratrol and the flavonoids, which include quercetin, rutin, luteolin and phycetin, just to name a few. Sometimes you can keep it simple and find a good antioxidant formula that contains most of these substances.

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The next cause of disease is allergies and sensitivities. The difference between an allergy and a sensitivity is that an allergy is truly an immune, mediated response, whereas a sensitivity is a substance that you don't tolerate well. It might, for instance, cause some gastric upset, but it's not a true allergic, immune, mediated response. As you know, allergies can be of many types. We can have allergies to foods, pets, pollen, latex, drugs and all sorts of things. If you have food allergies, it may be difficult to figure out what foods might be involved, and your provider or your allergy can help you sort that out. One of the best strategies is to start with avoidance. Immunization with an elemental diet or an autoimmune-paleotype diet might be helpful. There are also many drugs for allergies and some of these can be quite helpful, and there are also some natural therapies that have been helpful for many of my patients. These include curcumin, boswellia, willowbark, quercetin, especially for the skin, bromelain, especially for sinuses, and evening primrose oil.

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Next, let me mention mitochondria dysfunction. The mitochondria are the parts of the cells that transform the food you eat into a usable form of energy called ATP. Many diseases are caused by mitochondria dysfunction. Most of the ones that I saw more frequently were chronic fatigue syndrome and fibromyalgia. More recently, solid evidence has emerged that suggests that mitochondrial dysfunction may be a root cause of long COVID. I'll just mention electrolyte imbalance and acibase imbalance as another cause of disease. And the last cause of disease that I'll mention is mind body spirit dysfunction. We addressed that to some degree on our podcast number 32 on mind body medicine, so I won't go through that in great detail. And that completes the list that I have accumulated over the years of the causes of disease. I have used this many times as I've taken a functional approach to the patient's problems, figuring out the why to her condition, so that I could take a root cause therapeutic approach to her recovery.

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However, I also realized that many of these causes of disease are related to one another. For instance, mitochondrial dysfunction might be due to things like oxidative stress or toxins. So as I boiled it down to its very basics, it occurred to me that there are really just about four fundamental causes of disease. I've created a VIN diagram to illustrate this concept that you can find at McMinnMDcom in the documents section labeled as causes of disease. The four fundamental causes of disease are number one, the genome. Number two, the microbiome. Number three, the exposome, which means that what our bodies are exposed to, such as toxins, certain foods, socioeconomic factors, stress, lack of sleep, et cetera. And number four, the mind. And where these four factors intersect in the middle is where diseases emerge. It's really profound. If you take a minute to think about it, it's an entirely new and different, exciting approach to health and disease than we have been taught in the past. And again, this is not just a thought exercise. I actually used this list as a practical tool when a difficult patient presented to me and I was trying to connect the dots and figure out what was going on with her. So I hope that this has helped you in some way maybe to figure out your own situation and to get better, or to help you avoid disease until of a long, heavy life.

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Well, that will about do it for this episode of Wellness Connection MD. Don't forget to check us out at McMinnMDcom, where you can find the Wellness MD blog as well as lots of other great health and wellness information. Also, please help the podcast grow by telling your friends and family about us, and please take a moment to review us on iTunes. These reviews really do help us out. If you want to reach out to me by email, you can do so at drmcminnatyahoocom. You can also find me on Facebook, at facebookcom. I'll have all those links for you at the bottom of page one on the homepage of the website, which again is McMinnMDcom. Thanks so much for listening. This is Dr McMahon signing out. Take care and be well.

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