Integrative medicine最新文献

In this second part of my editorial on the untold/hidden history of Western medicine, I look at the many efforts of the past 2 centuries to balance disease medicine with health medicine. Many brave and visionary men and women founded and promoted health medicine movements, but few were successful. I present here an overview of the key movements, why most failed, and what changed to allow health medicine (by whatever name) to finally endure.

Parkinson's Disease (PD) is a complex neurodegenerative disorder traditionally identified by motor symptoms. However, non-motor manifestations such as lower gastrointestinal (GI) disturbances are increasingly recognized as early indicators and contributors to disease progression. This review examines the gut-brain axis and the role of lower GI issues, particularly constipation and gut dysbiosis, in the pathogenesis and management of PD. The "bottom-up" hypothesis suggests that PD may originate in the gut, with misfolded alpha-synuclein aggregating in the enteric nervous system before appearing in the brain. This pathological process is closely associated with gut dysbiosis, which contributes to increased intestinal permeability, systemic inflammation, and neuroinflammation via the vagus nerve and disrupted blood-brain barrier. Dysbiosis not only alters microbial diversity but also leads to the overproduction of neurotoxic metabolites, like lipopolysaccharides (LPS) and short-chain fatty acids (SCFAs). These biochemical changes create a pro-inflammatory environment that accelerates neurodegeneration. The review examines integrative interventions, including dietary strategies such as the Mediterranean diet and supplementation with probiotics, prebiotics, and synbiotics, which have shown promise in modulating gut microbiota and reducing inflammation. Lifestyle factors, such as exercise and stress reduction, also support gut health and symptom management, with structured multimodal exercise regimens showing significant benefit in motor function.

Introduction: Premenstrual dysphoric disorder (PMDD) is a hormone-sensitive mood disorder characterized by cyclical emotional and functional impairment in the luteal phase. Serotonergic dysregulation contributes to its pathophysiology.

Case presentation: A 38-year-old registered dietitian with clinically diagnosed PMDD consumed 5 tablespoons of whey protein concentrate (WPC) blended into a carbohydrate-rich smoothie daily for 8 days before menstruation, across 3 consecutive cycles.

Outcomes: The subject perceived substantial symptom relief (~ 80-95%), compared to her prior cycles and years of consistent symptoms. No adverse effects were reported.

Discussion: WPC provides a food-based source of tryptophan; co-ingestion with carbohydrates enhances tryptophan transport into the brain by increasing the Trp/LNAA ratio.

Conclusion: WPC may offer an effective and well-tolerated nutritional intervention for PMDD. Controlled trials are warranted.

For more than a century, the dominant model has been reactive: diagnose disease once symptoms arise, then apply treatments designed to manage or suppress them. But a new model-predictive, personalized, and data-driven-is rapidly emerging. This shift is propelled by the invention of new technologies that have introduced a radically different way of understanding health by integrating massive longitudinal datasets with artificial intelligence, imaging, and biomarker analysis. In doing so, it heralds the beginning of a fundamental redesign of the healthcare system itself.

The incidence of mental health disorders increased by about 40% from 2019 to 2023. The incidence of mental health disorders continues to escalate while the outcomes remain poor. The outcomes of psychopharmacology are mildly to moderately effective and rarely, if ever, result in a cure. The expectation is a lifetime use of medication for symptomatic management. The following case is an example of an integrative mind-body approach that may lead to an actual cure of psychiatric conditions when focused on neuroinflammation and not solely on neurotransmitters. The current case involves a young man who had been hospitalized seven times within seven years and treated with multiple attempts at various combinations of polypharmacy, resulting in similar outcomes and more hospitalizations. He sought a functional medicine approach due to the poor outcomes with conventional treatment. Subsequently, he was admitted to our outpatient facility utilizing a multi-systems model of an in-depth mind-body assessment. The treatment was based on inflammatory markers likely triggered by multiple toxin exposures, aimed at eliminating the sources of inflammation and introducing lifestyle and diet modifications to support detoxification. The outcomes obtained were extraordinary, with a total remission of all symptoms up to and including a post-treatment two-year follow-up assessment. This suggests that our approach to creating health outcomes needs to be personalized and integrative of both mind and body to achieve the best outcomes. The case presents an alternative approach to conventional treatment involving polypharmacy and psychiatric hospitalizations.

This article explores the expanded understanding of taste receptors and their role in health, with a focus on brassica vegetables. Recent research reveals that taste receptors are distributed throughout the body, influencing various physiological processes beyond simple oral taste perception. Brassica vegetables, also known as cruciferous vegetables, contain glucosinolates that convert into bioactive isothiocyanates, which interact with these widespread taste receptors. These interactions contribute to numerous health benefits, including anti-inflammatory, antioxidant, and potential chemopreventive effects. The study emphasizes the importance of educating patients about the holistic impact of brassica vegetables on health, proposing strategies to encourage their consumption despite initial taste aversions. This approach aims to reframe food as medicine within primary care settings.

Introduction: Customizing dietary supplementation for each patient based on biomarker testing could maximize a supplement's health benefits and minimize safety-related issues. This case report demonstrates an integrative provider's use of hormone testing to guide personalized supplement recommendations for their patient.

Case presentation: The patient was a healthy 47-year-old man who expressed interest in obtaining information about his testosterone levels. He underwent sex hormone testing using baseline serum measurement, as well as an at-home four-spot dried urine collection kit (DUTCH Test, Precision Analytical, Inc.) at baseline and before and after each intervention. Baseline serum free testosterone and urinary testosterone levels were at the low end of the age-dependent male reference range. Available genetic results also showed a catechol-O-methyltransferase (COMT) V158M polymorphism. The provider recommended human chorionic gonadotropin (HCG) to address low testosterone.

Outcome: After HCG treatment, testosterone increased as desired. A simultaneous above-range increase in estradiol prompted the provider to recommend a supplement containing calcium D-glucarate (CDG) and diindolylmethane (DIM). While CDG+DIM normalized estradiol, it elevated 2-hydroxyestrone (2-OH-E1) and 4-hydroxyestradiol (4-OH-E2) above range. In addition, the ratio of 2-methoxyestrone (phase-2 estrogen metabolite) to 2-OH-E1 (phase-1 estrogen metabolite) continued to decline further with each intervention, indicating a reduced capacity for estrogen detoxification, possibly related to the patient's COMT variant. To improve methylation activity, trimethylglycine was added, which normalized the 2-methoxyestrone/2-OH-E1 ratio. Finally, sex hormone and metabolite levels were within range, without any adverse events.

Discussion: Sex hormone and hormone metabolite testing before and after each intervention enabled careful step-by-step additions of supplements, which helped to improve testosterone levels while maintaining healthy estrogen metabolism. Given the patient's genetic background, this approach also ensured that any unintended effects on methylation were minimized. The convenience of the at-home dried urinary sampling method facilitated before-and-after testing.