01/02/2013 : Integrative medicine is the future of health care in our country. Doctors who specialize in integrative medicine study conventional medicine and realize its benefits. But they go on to study natural modalities of therapy including herbs, diet, acupuncture and homeopathy as a complement and supplement to traditional medicine. Because they combine the best of both of these approaches, they are called integrative doctors.

Doctors who practice this way realize that health is on a "spectrum." At one end, we have optimal well-being. At the other end, we have chronic disease, including cancer, heart disease and diabetes that we see so much in our society. What they have not told us in conventional medical school is that there is a "gray zone" in the middle, where organs are not sick or diseased yet. In the gray zone, organs get weakened, rundown, stressed, or toxic, and we realize that they are "dysfunctioning" but not yet diseased.

When organs dysfunction, we get a whole host of symptoms that doctors see so often in their practice. Without the integrative model, these health problems can only be treated symptomatically. Some examples of these problems are digestive problems like gas and bloating, migraines and other headaches, neck aches and backaches, and menstrual problems, including premenstrual syndrome. All of these conditions point to dysfunctioning organs that are in this transition zone on the chart.


One of the most important things that integrative medicine has taught us is to understand the concept of epigenetics, which is starting to be recognized by conventional medicine as well. "Epi" means "above." We now realize that our genes are not written in stone but rather are activated and affected by our environment. Epigenetics is the science that studies how environmental influences, which include diet, pollution, herbal medicines and drugs, affect genes and turn them on or off to either help or hurt our health.

One of mother nature's strongest epigenetic molecules is vitamin D. Vitamin D is not really a vitamin, but is actually a type of hormone called a secosteroid hormone, which acts similarly as steroids but with a slightly different structure. Only recently has science realized this. Because of its hormonal properties, vitamin D is now known to interact directly with more than 200 genes in our body. Vitamin D, when it's present in sufficient quantities, turns on or off these genes to bring us better health.

Vitamin D deficiency is now linked to 17 types of cancer. It is estimated that more than 1 billion people worldwide are deficient in vitamin D. Vitamin D deficiency during pregnancy and early childhood is now linked with our triple epidemics of juvenile diabetes, childhood asthma, and autism. Men with low levels of vitamin D had a 200 percent higher risk of heart attack than men with a normal vitamin D level, even with all other risk factors controlled for.

In one important study, it was estimated that if every woman in America increased her levels of vitamin D, we would reduce the incidence of breast cancer in our country by 50 percent! Women who had higher vitamin D levels at the time of diagnosis of breast cancer did significantly better over the ensuing 10 years than women who had low vitamin D at the time of diagnosis.

We normally get vitamin D from sunshine. However, dermatologists have recommended sunblock for years. In fact, the sunblock that blocks the bad rays of the sun from causing skin cancer also block our ability to absorb vitamin D. This is one reason why we have such an epidemic of vitamin D deficiency in our society. The amount of vitamin D that is added to milk or found in fish, such as mackerel, does not in any way give us the desired levels of vitamin D that we need in our body.

This is why in my practice, I recommend that everybody in America take a vitamin D pill every day throughout the year, and less in the summer if they are getting some direct sunlight that will create vitamin D with their own skin. But getting your vitamin D from the sun is a tricky business, because too much sun can obviously contribute to skin cancer.

In my book, The Vitamin D Revolution, based on many scientific articles, I recommend that the average American adult take 2,000 IU of vitamin D per day if they are otherwise healthy. Newborns should be started on 400 IU of vitamin D at birth, and children over 1 year old should take 1,000 IU of vitamin D every day until they are of adult weight. These are the recommendations in my book, and what I do with my patients in my practice. Of course, you should check with your doctor before you start taking any supplements.

In integrative medicine, physicians have very sophisticated tests to evaluate organ function in the gray zone that I discussed before. However, I realize that not everybody can afford or wants to go to an integrative physician, who is usually a fee-for-service type of doctor. I also realize a regimen of acupuncture, nutritional supplements, and herbal medicines may be too rigorous for some people.

For that reason, I have five recommendations to minimize your risk of chronic degenerative disease:

  • Keep your body mass index (BMI) under 25.
  • Exercise 30 minutes daily (or 3.5 hours weekly).
  • Emphasize a diet of plant-based whole foods and reduce your meat consumption.
  • Take vitamin D -- 2,000 IU per day, if it's okay with your doctor.
  • Find some type of "centering" practice to keep yourself mentally and emotionally centered -- for example, yoga, meditation or tai chi. I do Kundalini Yoga. Dr. Oz does Transcendental Meditation.

This list fits very well with a recent study that was published in the Archives of Internal Medicine. People in that study who had all four of these factors (below) had a 78 percent lower risk of getting any chronic degenerative disease, including diabetes, heart attack, strokes, and cancer.

  • Never having smoked.
  • Body mass index less than 30.
  • Participated in physical activity 3.5 hours per week or more.
  • Healthy dietary principles, which included a high intake of fruits, vegetables, and whole grain bread and low meat consumption.

I think adding vitamin D, as I do in my list, to the above study would further lower the risk of getting chronic degenerative disease. The current system of spending so much money on pharmaceutical medications for problems that would be best addressed by lifestyle factors and natural therapies puts us on a course of self-destruction. Eventually, the money will run out.

In summary, I think the increasing recognition of integrative medicine and the role of lifestyle in our health will play a more and more prominent role in the future of health care in our country. I hope with this transition we can truly migrate from a disease-care system to one of true proactive health care.

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Dr. Soram Singh Khalsa, M.D.

Dr. Soram Singh Khalsa, M.D.

Dr. Soram Khalsa is an internist in Beverly Hills, California and is affiliated with Cedars-Sinai Medical Center. He received his medical degree from Case Western Reserve University School of Medicine and has been in practice for more than 20 years. He specializes in Internal Medicine and Integrative Medicine combining diet, nutrition, acupuncture, herbs and nutrition.

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