Category Archives: Chronic Disease

The Cost of Chronic Disease

December 20, 2017

The primary issue that consumes the majority of the burden of healthcare costs in the United States is preventable chronic disease: while the most prevalent health conditions are simultaneously the most avoidable, they continue to cost the country’s budget billions of dollars. While overall numbers have decreased since 2010, when chronic disease cost the U.S. a total of $315 billion, morbid obesity rates have continued to rapidly spike—a condition that leads to a range of critical health issues including heart disease, diabetes, and stroke.

Primary care providers have long faced the struggle of determining how to implement best practice care for patients diagnosed with chronic diseases. Recent studies indicate that almost half of the entire U.S. population has at least one chronic health condition—including heart disease, cancer, diabetes, obesity, or arthritis. Statistics designate these health care treatments costs to account for 86% of cumulative national healthcare spending, and the CDC reports that chronic conditions are the leading causes of death and disability in the country.

Yet the past decade has seen the advent and proliferation of digital health technology, spurring the generation of new techniques and strategies for healthcare professionals to utilize in chronic disease management. These types of technology vary in terms of accessibility and usability, but include remote monitoring, mobile health apps installable on phones, and wireless wearables—which serve as activity trackers.

A series of interviews conducted by Medical News Today demonstrate a bright future for the potential of new technology, and its ability to spur and provide high-quality care. Suzanne Falck, MD, an associate professor of internal medicine at the University of Illinois College of Medicine, noted that a highly successful digital tool is currently in use for the management of heart failure: an implanted sensor immediately transmits data to a healthcare practitioner, who then analyzes the data in order to make medical recommendations. Further clinical trials and studies indicate that remote monitoring is more cost-effective than traditional, conventional management.

Moreover, the burgeoning popularity of medical apps signifies that mobile technology can make a hugely positive impact on chronic disease management. There are currently approximately 259,000 medical health apps available to purchase; over half are aimed at targeting consumers with chronic conditions. Clinical trials have repeatedly shown that patients with type 2 diabetes who utilized an app to monitor their blood glucose levels showed greater benefits than those who did not. A recent article in Diabetes Technology & Therapeutics states that the prognosis in patients with diabetes is ‘strongly influenced by the degree of control of their disease,’ which reinforces the effectiveness of self-management support through mobile apps.

Another innovative and exciting development is wearable technology and devices, which are currently being studied in a variety of clinical research settings. Many healthcare providers believe that the ‘potential of this technology is endless,’ as they can improve access to care while simultaneously enhancing convenience—and likely patient compliance.

Most importantly, being conscious of medicinal needs and treatments requires a consistently high level of responsibility and awareness. Healthcare experts urge patients to take active, informed roles in managing their health: online workshops have been developed to offer chronic disease self-management programs, which have been proven to significantly improve health statuses. Moreover, healthcare practitioners and professionals must collectively work together and utilize the new landscape of digital medical technology to their patients’ benefits.

InternalMedReview – Inflammation Induced Chronic Fatiguing Illnesses

October 18, 2017

This is the state of the science regarding genomics and neuro-inflammation due to Lyme and Mold exposure. The premise is that the common presenting symptom of fatigue is caused by chronic inflammation, which can now be objectively measured and treated when due to a biotoxin exposure. This is breakthrough research and links inflammation, brain injury and underlying genomics. We are the only group in the world to publish these findings based on years of careful research. – Andrew Heyman, MD

We hear so much about genetics vs. genomics here at A4M/MMI, but the bottom line is that a huge leap was just made this month in our main mission. One of our leading faculty members, Andrew Heyman, MD who is also the Program Director of our Fellowship at George Washington University, just had his research published in The Internal Medicine Review’s October Issue.

Dr. Heyman along with another one of our expert faculty members, Dr. Richie Shoemaker, partnered in this research initiative and have worked tirelessly to gather this data. They are the only group in the world that has collected this amount of data in the chronic illness arena. As we continue to review the model of genomics, what is causing chronic disease – between genetics, DNA, RNA, etc. we have begun to become aware of an overlap with other conditions that we usually blame on lifestyle like obesity and diabetes, etc.

Is the presence of mold or moisture in our surroundings starting to shift our immune response?

Below we provide a summary on some exciting new insight into chronic diseases.

Inflammation Induced Chronic Fatiguing Illnesses: A steady march towards understanding mechanisms and identifying new biomarkers and therapies.

Ritchie C. Shoemaker1,4*, Andrew Heyman2, Annalaura Mancia3 and James C Ryan4
1Center for Research on Biotoxin-Associated Illnesses, Pocomoke, MD, USA
2Integrative Medicine, George Washington University, Washington DC, USA
3Department of Life Science and Biotechnology, University of Ferrara, Ferrara, Italy
4ProgeneDX, LLC, Deerfield Beach, FL USA

This breakthrough peer reviewed publication outlines the Chronic Inflammatory Response Syndrome (CIRS), an evidence-based model of assessment and treatment of Chronic Fatigue utilizing objective biomarkers, structural Brain MRI and transcriptomics, and moves medicine away from a ‘symptom only’ approach to managing the fatigued patient. CIRS is a neuroregulatory-inflammatory disease process found in genetically susceptible patients (20% of US population), initiated by exposure to a biotoxin(s) such as a water damaged building, Lyme disease, ciguatera, pfistera and many more. A final common pathway of immune dysfunction ensues, including abnormal findings such as Transforming Growth Factor Beta (TGFb), Vasoactive Intestinal Peptide (VIP), Melanocyte Stimulating Hormone (MSH), split products of complement activation, Matrix Metalloproteinase (MMP9) and others now available for use as clinical diagnostics. In cases of cognitive decline, new technology for brain MRI analysis, NeuroQuant, can pick up small changes in brain structures consistently shown in CIRS.

This work is based upon two randomized controlled trials applying a specific series of assessments and treatments designed to restore normal health status by:

1) eliminating the exposure
2) resolving immune dysfunction
3) repairing damage to the central nervous system

The CIRS protocol finally gives the practitioner a clinical roadmap for some of their most complex patients presenting with fatigue, especially those suffering from Lyme disease. This article offers clear, concise guidance on the diagnostic and therapeutic approach to define both an initial infectious process and a subsequent inflammatory illness and outlines how genomic testing can determine predisposition to chronic stages of Lyme after acute illness through use of Next Generation Sequencing to bring transcriptomics to the Lyme community.

The goal of this important scientific work is to help practitioners reduce uncertainty in their management of the CIRS patient and to ensure a rigorous, evidence based assessment and treatment process is applied utilizing both conventional and Integrative treatment strategies. It represents a new era in clinical medicine by applying a novel language of neuroimmune and genomic profiling, in order to guide health providers in their treatment of Lyme disease, mold exposure and other biotoxins.

Future research will focus on refining the treatment protocol, determining the role of transcriptomics in chronic inflammatory processes and exploring the relationship and overlap between CIRS and other common conditions such as cardiovascular disease, diabetes and obesity, chronic pain syndromes, concussion and brain injury, and neurodegenerative disorders.

On Friday, December 15, 2017 during our 25th Annual A4M World Congress, Dr. Heyman will be lecturing at our VIP breakfast symposium titled See the Forest through the Trees: Protocols for Lyme Disease, where he will cover what can reduce symptoms, of Lyme, strengthen the immune system, and potentially treat the entire illness.

If you are interested in furthering your coverage of the treatment of Lyme and other chronic illnesses, Dr. Heyman and Dr. Shoemaker have a two part online advance course that we offer.

National Celiac Awareness Day

September 15, 2017

September 13th of each year marks National Celiac Disease Awareness Day. This day was created in order to honor those affected by celiac disease, raise awareness about the disorder, promote educational initiatives, and commemorate the birth of Dr. Samuel Gee who was a pioneer in celiac disease research.

Celiac disease affects approximately 3 million Americans, yet it is often undiagnosed or misdiagnosed due to the very slow, gradual bodily damage, and the fact that the symptoms are so widely varied. Diagnoses of celiac disease can sometimes take years.

This autoimmune disorder is triggered by the consumption of gluten: a protein found in wheat, rye, and barley; when people with celiac disease eat gluten, their bodies mount an immune response that attacks the small intestine—ultimately triggering damage that disables the body from properly absorbing necessary nutrients. This can eventually lead to malnourishment, in addition to loss of bone density, miscarriages, infertility–even the onset of neurological diseases and certain cancers.

There are no pharmaceuticals or drugs that treat or cure celiac disease. The only fully effective treatment for the disease is a 100% gluten-free diet, yet Nexvax2—a therapeutic vaccine designed to protect patients with celiac disease against the effects of gluten exposure—has been largely effective in several randomized controlled trials, through its ability to alter a patient’s immune response to gluten.

In order to learn more about autoimmune and inflammatory disorders like celiac disease, sign up for our Fellowship in Metabolic, Nutritional and Functional Medicine. Module VII: A Metabolic and Functional Approach to Inflammation & Autoimmune Disease primarily focuses on autoimmune and inflammatory diseases through the gut-immune-brain connection.