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Joanne Pizzino, MD, MPH

Joanne Pizzino, MD, MPH is board-certified in Preventive Medicine, and Diplomate-certified in Integrative Medicine. She has been practicing Functional Medicine since 1998.

Dr. Pizzino is one of the Functional Medicine specialists on the Parsley Health team. Feel free to refer your friends and family. She is licensed to treat patients in the following states: NC, AZ, CO, DC, FL, IN, KS, KY, MD, MA, MO, NH, ND, SD, TX, WV, WY. Parsley Health doctors are available in most other states.

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Cause and Effect

By Joanne Pizzino, MD, MPH
Medical Editor of Health&Healing

Dr. Pizzino

Pain and pleasure are the two great motivators for humans. Of these, the need to avoid pain is usually more compelling than the yearning for pleasure. If we define pain as anything that limits or constricts us, we could use this word to encompass the spectrum of dis-ease in both body and mind.

When something constrains us from leading the life we desire, our survival instinct kicks in, obliging us to find a solution quickly. The modern science of chemistry has afforded us many such “solutions.” Unfortunately, most of these remedies, especially when used for chronic disease, are applied to the effects of the problem that got our attention. For problems such as heart disease, cancer, autoimmune diseases, osteoporosis, or dementia—which may have been decades in the making—bubble gum and bailing wire may close the first leak, but do not stem the ultimate cracks that destroy the system. And when we just keep adding more patches, we become dependent on patching material, which eventually runs out or fails. We need to go upstream to find the root cause of the problem.

When we work at the level of cause (which is the science of Functional Medicine) we can support the tremendous power naturally built into the body to heal itself. The technical term for this ability to get back into balance is homeostasis. While we have developed a cultural idea that the patches are necessary, in truth, none of them works without homeostasis. At best, treating effects buys us time to work on the root causes. In chronic disease, these quick or convenient “solutions” usually become crutches that allow us to limp along until the next effect hobbles us even more. At worst, they actually compound the problem by adding side effects that shift the body’s ability even farther away from being able to right itself.

One common example of this are the statin medications used to lower high cholesterol, which is blamed for causing heart attacks. Few things get one’s attention like a heart attack, so most of us will grasp at whatever lifeline is thrown to us, often completely unaware of what is on the other end of the rope. But, did you know that high cholesterol accounts for less than half of heart attack cases? And, while studies show statins definitely can prevent a second heart attack, they are not really good at preventing first heart attacks, so using them to lower a laboratory number may not be a very effective strategy. And, as it turns out, cholesterol is merely a signpost along the path to clogged arteries, not a root cause.

Chronic inflammation has been proven to be the source of high cholesterol, as well as most diseases of aging, including everything from atherosclerosis to Alzheimer’s dementia, from cancer to Crohn’s disease. In continuing our search for a root cause, we need to ask, where does chronic inflammation come from? The answers: a pro-inflammatory diet, lack of exercise, hidden infections, and toxins.

The Problem of Treating Effects, Not Causes

While statins do have anti-inflammatory effects, they do not address these root causes, so the body stays out of balance. Is it any wonder then, that statins have been associated with an increased the risk of diabetes? And what about their known negative side effects on the liver? Some people are forced to stop taking them because of a rise in liver enzymes, but did you know that the lab numbers for liver enzymes don’t go up until about 80 percent of the liver is affected? What are statins doing to the livers of the rest of us with normal numbers? How might this add to the burden our livers are already dealing with from pesticides, plasticizers, perfumes, and the other thousands of chemicals to which we are exposed in modern life?

This is a question we must ask ourselves whenever any medication— prescription or OTC—is added to our systems. If for instance, you think you no longer have asthma, allergies, or high blood pressure because you take an ongoing medication that controls it, consider again that you have not gotten the body back into its own natural balance, but are just propping it up with crutches.

The Danger of Medication Side Effects

Perhaps one of the most daunting medication side effects we are just beginning to learn about are the mitochondrial poisons. Mitochondria are those little powerhouses in our cells that turn our food into energy. This is not just our get-up-and-go energy, but also the energy to do everything else our bodies do: fight infection, make neurotransmitters and hormones, clean out toxins, etc. Statins were one of the first medications recognized to affect mitochondria, but the list of medications causing this devastating but often invisible side effect is long and growing. It includes tetracycline, fluoxetine, and metformin. Could this be why you have noticed you are now more tired, or more brain fogged, or get more infections, or heal more slowly, or are simply more generally achy than when you went on a certain medication?

While the desire to end pain and dis-ease is natural, along with the inertia that leads us to pick quick and convenient options, could we be robbing Peter to pay Paul? Is our preference to pop pills instead of going the often more challenging route of correcting root causes really worth the price? Americans take more medications than any other culture on Earth, and are also the sickest by many measures. We lead the world in number of years of disability before death. Who wants to spend more time in a nursing home? Does it really make sense to try to cover up a lifestyle problem with a pill? In a culture which says we have to keep pushing ourselves relentlessly, whether at work or play, perhaps we make that short-term choice. Still, we must ask ourselves if being in the game today is worth decades suffering on the sidelines. Do you want to just be in today’s game, or are you willing to correct the root cause so that you can play for decades?