By Team at the New School
You may have seen the video sketch with the woman (we are calling her Mary) who has arthritis and was taking Ibuprofen, if you missed that video, you can watch it HERE
This sadly is all too common in the 21st century, one medication leading to the prescription of another, then another etc. and some due to the side effects of the medication being prescribed.
For Mary, the Ibuprofen was not helping much, so she was prescribed Prednisone (a steroid based medication). From this medication she experienced heart-burn, for which she was prescribed Omeprazole and started experiencing nausea. She was prescribed Ondansteron for nausea alongside the Omeprazole, then she was experiencing heart flutters for which she was prescribed Metoprolol. Her legs began to swell on the Metoprolol for which she was prescribed Frusemide, then she was unable to walk much and her blood pressure shot up! You may think this is just a video sketch, but this is real life for people.
Have you experienced something similar or know anyone experiencing this? We want to share how we at the New School of Nutritional Medicine would approach this.
Our Approach at the New School
First and foremost we get to know and understand Mary's concerns
We will ask Mary what does she want? She may want to be free from pain, she may want to be on medications but without the side effects, she may want a more natural approach without the side effects, as life coaches we ask what is it that SHE wants, not what we want for her. We keep a beginner's mind and we remain curious.
We may use cognitive restructuring, whereby we ask about her experience:
What is helping her?
What is not helping her?
What has she found helps?
What does she believe and/or feel is a better way of approaching her health concerns?
These questions also help Mary reflect on her experience and also for us as coaches to listen and understand her concerns and goals and challenges without our own bias.
Together we explore options, we may use the Lotus Blossom technique with the various options to create new ways of moving forward. We may find that Mary is not ready for the big changes and may require small manageable steps to start with.
We inquire into the pain, as the causes of pain can vary, the pain may be physiological, it may be more somatic. That is not to say it is in Mary's head, but is the pain better at certain times, is it worse under stress, does it move around? And if this is the case, we may approach this through pain re-processing coaching. We may discover this pain Mary is experiencing can be psychological, emotional, cognitive, behavioural, physical, or environmental, or context-related. We would explore all these possibilities with this Mary.
We may discover that she is fearful, she may not have support, she may be under pressure to be on medication from family members. She may be responsible for grandchildren during certain days of the week and maybe a 'people-pleaser' who does not have boundaries and cannot say no. She may be feeling that her grandchildren although wonderful, are too energetic for her pace of life nowadays. These are all areas that may 'surface' as we coach.
We all have fears
We may discover that Mary's fear is of losing her job, and yet she does not enjoy her job, it just about pays the bills. She may have never considered other options before seeing an integrative life coach with a nutritional medicine specialisation. These options may bring up deep fears that have been around for a long time, so as integrative life coaches we could show her ways to;
i. approach those fears
ii. to have a different relationship with her fears.
This can involve talking through any fears Mary may have and also giving her space and the tools to make a few changes in between sessions.
Once we have gotten to know Mary, we tailor her 'programme' to her unique needs. It may be she just needs someone to hear her, nothing more from the first session.
The power of being heard is medicine itself
If Mary decides she wants to be medication-free as much as is possible, then as nutrition medicine practitioners we look into the medications she has been taking in the last year or so. We will investigate their impact on nutrient depletion if any, their mode of action and any contra-indications to any supplements that may be recommended. She will work with her prescribing doctor on the medication withdrawal or changes.
We also look into her timeline to see when the health issues started, when did her body start communicating that it was out of balance, was there any major stress such medication/toxin 'insult' e.g. a general anaesthetic or a series of antibiotics, brith control pill, intense dental work, etc or any mental/emotional stress such as loss of a loved one, children leaving 'the nest', and/or infection such as a virus etc.
Inflammation
Arthritis is an inflammatory condition, in order to ease any physical pain, reduction in inflammation would be the first few steps. Balancing the blood sugar, focusing on meal times, and food prep. Balancing blood sugar will reduce inflammation but also provide better production of ATP (our currency of energy).This is all analysed and discussed with Mary only after having understood Mary as a whole person, her desires, her fears, her dreams. Mary has a story and her story matters and helps us put together a more personalised plan that works for her.
Inflammation is also dictated by cell membrane health, the type of fatty acids that are making up the cell membrane. It is not only the omega 3s that are vital but the saturated fats including the more recent essential AND saturated fatty acid.
The food we eat impacts the composition of our cell membrane, this cell membrane can be 'pro-inflammatory' in nature or anti-inflammatory. We chose our functional tests wisely, as not all functional tests for fatty acid analysis analyse the vital fats.
Pain before medications
Once we identify what Mary's pain was/is like before medications, we can recommend some supplements therapeutically, for the time being, whilst we work on the underlying issues with a root cause medicine approach.
With this lifestyle medicine approach we will also encourage nutrient dense foods. Some of the medications Mary has been taking have a nutrient-depleting action. For example, Ibuprofen which is a Non-Steroidal Anti-inflammatory Drug (NSAID) can deplete some vital nutrients such as folate, selenium, vitamin C and calcium. These in themselves can lead to side effects, such as low energy, inability to heal and repair, increase in further inflammation, low immunity, osteoporosis, etc. You can read more about drug-induced nutrient depletion HERE.
Omeprazole impacts the gut microbiome, creating all manner of dysbiosis, which can impact overall health and well-being and can further aggravate the inflammation which can cause further pain.
Omeprazole provides an environment for the over growth of H.Pylori, this in itself will create further digestive issues, even though Omeprazole was originally prescribed for the heart burn that was triggered by the previous medication. Most heartburn aka acid reflux is usually due to low stomach acid not high.
As we age our stomach acid reduces...so why are some of the more mature in age taking antacids?
We want to ensure that Mary has enough stomach acid, as this is vital for digestion, absorption and assimilation of nutrients from her nutrient-dense meals. Omeprazole also depletes calcium, iron, folate, vitamin B6 and vitamin B12. Every one of these nutrients has vital roles in our physiology. B12 is vital for making red blood cells which carry oxygen (so Mary may experience low energy or fatigue), B12 is also key in DNA synthesis, cell growth and replication in other words, healing and repairing and not to mention B12 plays a ket role in making neurotransmitters such as serotonin.
We may look into doing some functional tests (such as a comprehensive gut test, essential and metabolic fatty acid test profile test that includes the essential SATURATED fatty acid) , but we can start with a simple blood test from her doctor, to check ferritin, iron, HbA1c, minerals, liver enzymes to name a few markers.
Ibuprofen: inhibits enzymes that create inflammation
Prednisone: suppresses the immune system
Omeprazole: proton pump inhibitor
Ondansteron: 5HT type 3 receptor blocker
Metoprolol: beta blocker
Frusemide: diuretic
The reality is Mary does not know that these medications would be reducing her nutrient levels and some of the most vital nutrients such as folate. Folate is also another key nutrient for making new cells and joints require folate and B12 to heal and repair. This nutrient depletion hinders the healing and repairing process.
We talk through Mary's medications with her and explain their impact overall, not just the pharmacological mode of action and why nutrient dense foods are vital for her wellbeing.
Mary's leg started to swell from the Metoprolol as it is a beta blocker and beta blockers slow down the heart, thereby fluid retention and pooling can become an issue. Although this may address the heart flutter, Mary's treatment with medications alone is creating a sick patient for life.
Unfortunately Frusemide, makes the body 'pee out' more water through the excretion of sodium, but the swelling is due to the beta blocker, not due to excess sodium in the body. So why is the beta blocker not being re-addressed?
Sodium is a vital mineral, it is key in heart health, mental wellbeing as well as making stomach acid! Unfortunately, Frusemide also starts to remove potassium from the body, and this mineral is low in most people, but it's role in the body is CRITICAL.
One of potassium key role's in the body is cell to cell communication, imagine if you were not able to communicate with. your loved ones, this is how the cells start to lose their connection with each other. Potassium also is important in helping the heart contract, so a beta blocker that slows the cardiovascular system, then loses potassium from the diuretic, the heart can slow down even further. Potassium is also crucial in maintaining the acid-base balance in the body without this balance, our body would not be able to function well.
The gut
We cannot ignore the health of the gut. A comprehensive stool test would reveal some of the key issues that may be leading to the physical pain of the arthritis and the some of the causes of arthritis. (more on comprehensive stool test HERE).
Did you know that a 'leaky gut' can be a cause of inflammation in the joints or any where else INSIDE the body?
The microbiome has become so trendy, but we remind our students that before the microbiome we have the nervous system that whispers or shouts 24-7, the chewing of food, oral health, the parietal cells that produce the wonderful acid to kill of the unwanted microbes and toxins before that food goes any further down the digestive system, we remind them that the gall bladder is not just an organ that 'stores bile and emulsifies fats'.
We teach our students to listen and listen, then listen some more to their clients. This way, they can then ask the right questions to support their clients with personalised lifestyle medicine.
As our students qualify as nutrition therapists and integrative life coaches, they have the skills to support and help people achieve their wellbeing goals using science based teachings, including functional tests as and when required.
Our students also cover naturopathic approaches to healing which includes potentised remedies such as bowel nosodes, cell salts, cleanses and detoxes.
Introduction to Humma
This is Humma, one of our overseas students sharing her journey so far at the New School of Nutritional Medicine.
Want to join us?
To Wholeness!
From the team at the New School Of Nutritional Medicine
Learn about the Founder & Principal of the New School of Nutritional Medicine, Dr Khush Mark PhD HERE.
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