BY Samuel Mathis MD, MBA
“There is no right way to live with your chronic illness. There is only YOUR way.” – Unknown
There is a distinct burden for patients living with chronic disease. This burden is felt physically, emotionally, financially, and even socially. Patients with conditions like hypertension, diabetes, thyroid disorders, coronary artery disease, arthritis, fibromyalgia, stroke, and cancer (to name a few) all have significant stress associated with the condition. Chronic diseases are now the leading cause of death worldwide and create significant morbidity for other conditions such as respiratory infections, or trauma. Fortunately, conventional medicine has advanced to such a place that these individuals live longer lives, but with that advanced age comes even greater struggles such as aging with a chronic disease. It is estimated that the cost of chronic disease will exceed $47 trillion worldwide by 2030 (1). I cannot even begin to imagine a number that large and how it affects the global economy, let alone my own community or even the individual.
How does integrative medicine help reduce the burden of chronic disease? One way is through prevention. One goal of integrative medicine is to improve health through diet and nutrition. Studies have shown that healthy food choices and regular exercise are the cornerstone of a healthy lifestyle. The CDC has found that fewer than 10% of all children and adults in the US eat their recommended amount of vegetables. We must do better. A 2009 study found that patients were 35-55% more likely to stop smoking, improve their diet, or even start exercising if a physician talked about these changes compared to those who received literature encouraging them to make these healthy lifestyle changes (2). The study also found that “Physician counselling is strongly related to one’s own health practices, so addressing [physician’s] own health [behaviors] is key to substantially increasing health promotion counselling in general practice” (2). If we improve our own eating habits and exercise routine, we are more likely to encourage our patients to do the same.
The second way to improve chronic disease is to encourage regular physical activity. By tackling diet and exercise, we can reduce the rates of obesity in our population (estimated to be 40% of adults and 20% of adolescents). Just 20 minutes of moderate intensity activity (like a brisk walk) has the potential to improve life expectancy by 2-5 years and reduce rates of cardiovascular events like heart attacks or strokes. I’m ashamed to admit it, but it has been some time since I have exercised, and I haven’t been recommending it as often as I should. I’m a prime example of when we are living a healthy lifestyle, we are more apt to recommend it to our patients.
Patients are utilizing other integrative therapies such as herbs, supplements, mind-body medicine, acupuncture, and other activities in addition to conventional medicine. However, they rarely disclose the use of these therapies to their physician. Having open communication regarding these supplements can be very helpful in preventing complications or interactions. Many of these practices are part of the patient’s self-care regimen as opposed to rejection of conventional medicine or recommendations (3). Communication is vital. I encourage you to review your field and gain a cursory understanding of what primary supplements patients may use for their condition.
There are numerous supplements for differing conditions, but some have an effect across the spectrum of disease. Anti-inflammatory supplements such as Omega 3 Fatty Acids, Turmeric, Vitamin D, and Magnesium have significant research behind their benefits for numerous conditions. Omega 3 fatty acids are best obtained through cold saltwater fish and seafood. Turmeric is a powerful spice that we are only beginning to scratch the surface of its health benefits. Vitamin D plays a role in so many aspects of our lives and many Americans (who do not regularly exercise outdoors) do not get nearly enough of it to remain in the optimal range. Magnesium is another fantastic supplement that plays an important role in gut, musculoskeletal, and brain health. Many of our patients’ conditions would improve if they started obtaining or supplementing with even just one of these four supplements.
Lastly, let’s not forget the emotional toll that disease has on a patient’s life. While it is very draining to treat people with the same conditions because of unhealthy lifestyle choices, our patients must experience life with these conditions and live in fear of their complications and outcomes. Empathy and compassion can go a long way to ensuring patients know how much we care about them and their health.
References:
- Hacker K. The Burden of Chronic Disease. Mayo Clin Proc Innov Qual Outcomes. 2024 Jan 20;8(1):112-119. doi: 10.1016/j.mayocpiqo.2023.08.005. Erratum in: Mayo Clin Proc Innov Qual Outcomes. 2024 Dec 13;9(1):100588. doi: 10.1016/j.mayocpiqo.2024.11.005. PMID: 38304166; PMCID: PMC10830426.
- Oberg EB, Frank E. Physicians’ health practices strongly influence patient health practices. J R Coll Physicians Edinb. 2009 Dec;39(4):290-1. doi: 10.4997/JRCPE.2009.422. PMID: 21152462; PMCID: PMC3058599.
- Thorne S, Paterson B, Russell C, Schultz A. Complementary/alternative medicine in chronic illness as informed self-care decision making. Int J Nurs Stud. 2002 Sep;39(7):671-83. doi: 10.1016/s0020-7489(02)00005-6. PMID: 12231024.