Interview by Sheldon Baker
Dr. Joseph Pizzorno, ND is a transformational leader in medicine. He has helped establish and advance the academic, scientific, and clinical standards for natural, functional, integrative, and environmental medicine through half a century of work. As founding president of Bastyr University in 1978, he coined the term “science-based natural medicine” and led Bastyr to become the first-ever accredited institution in the field. He has set worldwide standards by authoring or co-authoring 6 textbooks for doctors, including the Textbook of Natural Medicine (which has sold over 100 000 copies in 4 languages across 5 editions) and Clinical Environmental Medicine (the most widely used textbook in its field). He is Editor-in-Chief of PubMed-indexed IMCJ—the most field’s widely read, peer-reviewed journal (25 000 copies each issue). He is a founding member of the Board of Directors of the Institute for Functional Medicine where he recently finished serving his third term as Chair of the Board. He has been extensively involved in public affairs as a founding board member of American Herbal Pharmacopeia and as a member of the science boards of the Gateway for Cancer Research, the Hecht Foundation, and Bioclinic Naturals. Presidents Clinton and Bush appointed him to two prestigious government commissions to advise Congress on how to integrate natural medicine into healthcare. A licensed naturopathic physician, educator, researcher, and expert spokesman, he is also the author and co-author of 8 consumer books (most recently, Healthy Bones, Healthy You! with his wife Lara). His newest book, The Case for Dietary Supplements, will be released in 2024. To help make this extensive body of knowledge more accessible to clinicians and consumers, he has developed artificial intelligence tools that unravel the complex needs of each unique individual. Recently he began advancing the concept of Health Medicine to encompass the promotion of health and resilience as a critical balance to the limited practice of only treating disease. He has received prestigious lifetime achievement awards for his work from leading organizations, such as the Institute for Functional Medicine (IFM), the Academy for Integrative and Health Medicine (AIHM), the Integrative Health Symposium (IHS), the American College of Nutrition (ACN), the Natural Products Association (NPA) and the American Association of Naturopathic Physicians (AANP).
Sheldon Baker is an InnoVision contributing editor. His freelance editorial content can also be found in several lifestyle publications, and as CEO of Baker Dillon Group LLC, he has created numerous brand marketing communications and public relations campaigns for health and wellness organizations. Contact him at Sheldon@NutraInk.com.
Integrative Medicine: A Clinician’s Journal (IMCJ): Talk about the current health status in the U.S. In your estimation, what is the number one public health problem facing today for men and women.
Dr. Joseph Pizzorno, ND: Easy answer, the ill health of our society. We now suffer the highest burden of chronic disease in every age group ever in human history. The medical apologists dismiss the high incidence of chronic disease due to people living longer . The problem with this assertion it that even though people, up until recently, are living longer, people in all age grouped have more chronic disease. The other part is, we’re not actually living longer anymore. Starting about five years ago, the projected longevity at birth started going down and while people might say it’s because Covid made it worse, it was already happening before Covid. People being born now predicted to live a shorter lifetime than their parents. This is the first time in the history of our country that this has happened.
IMCJ: Based on that, what would you say are the biggest threats.
Dr. Pizzorno: Why is this happening? I think there’s a combination of three factors. There may be more, but I’m just going for three right now. Number one, we’ve made our environment more toxic. We filled our environment with toxic metals and chemicals. There is some encouraging examples where we became aware of this problem as a society and engaged public health efforts to address the problem. We’ve had success, for example, lower levels of lead, and stopping DDT and PCBs being released into the environment. So, the good news is that in general the levels of those toxins in humans have gone down. Not a lot, but they have gone down. The problem is we’ve continued to pollute our environment with other medicine chemicals. So body load o these other metals and chemicals has increased quite substantially over time. There are many examples where people became concerned about toxins, such as BPA (Bisphenol A) and manufacturers decreased their use of BPA. Unfortunately, they put other bisphenols in instead, like Bisphenol S. Bisphenol F. They’re every much as toxic to humans as BP. We just don’t have as long as history to recognize how much toxicity is going on. So, the body load and verodoxins has gone up so it’s easy for people to dismiss.
Number two we have rampant nutritional deficiencies, and these deficiencies are not just the 44 vitamins and minerals which have been officially considered required for life. However, if you look at plants around the world over 50,000 molecules have been identified so far. While they are not required for life, they are required for health. We decide that less than 50 of these, less than 0.1% of the total are important and everything else is not important. The problem is when you grow foods chemically rather than organically. these other molecules are lost. People talk about and promote miracle phytonutrients in super foods. All they’re doing is replacing molecules that should have been in our diet to begin with, and that we lost because we grow foods chemically.
The third reason, and this could be a little more controversial, but I can point to thousands of research articles that support what I just said about toxins and nutrition. The third problem is that conventional medicine’s drug approach made it too easy for people to ignore the damage to their bodies from living unhealthily. Iif you look at the most common prescribed drugs, not the most expensive, but the most common prescribed drugs, all they do is alleviate the symptoms or the blood measures of dysfunction in the body, but they don’t correct the abnormalities. So, what happens is people have less symptoms for the short term, but in the long term the body is breaking down, and they’re getting more disease.
The old-time naturopath doctors a hundred years ago, men and women who started this profession, asserted that if you treat disease with suppressive medications you get more chronic disease. We now know they were prescient.
What they meant by “suppressive interventions” was you’re suppressing the symptoms without addressing the causes of the disease. Symptoms are the body’s messages that the body is breaking down. By using drugs to turn off those messages you’re not stopping the body from breaking down, but of course you can get more chronic disease.
IMCJ: I read just this week that what you eat at 40 may affect how healthy you are at 70.
Dr. Pizzorno: Well, I believe it’s so real in my own life right now. My wife and I are now in our mid-70s.We’ve lived healthfully since our 20s and are functioning very well. Sadly, too many of our family and friends—who did not adopt a healthy diet and lifestyle—are dead, have debilitating chronic disease, or they’re done with life and just sit in front of the TV. There’s so much more to life.
IMCJ: Do you agree that our public health efforts are not organized for success?
Dr. Pizzorno: I would put that a little differently. The greatest improvement in human longevity and the greatest decrease in disease has been due to public health. Public health has produced a huge benefit by basically cleaning up the food and the water supply, so it’s not poisoned with contaminated organisms that causes infectious disease. That’s been a huge public health benefit, but unfortunately, and number one, we don’t spend much on true public health anymore.
Another problem is that much of public health is now being spent on providing services for people who don’t have the funds to provide their own services. I learned a lot when I served on the Seattle King County Board of Health where I for six years. The King County Board of Health is the 12th largest health board in the country in terms of the size of the population that it serves. I admire and appreciate the public health people, you know they were right on, but they were constrained by budgetary limitations. I looked at how we’re spending our money. At that point my estimation was that only 5% of our budget was spent on true prevention, All the rest was spent on dealing with the adverse effects of disease or providing clinical services.
IMCJ: It’s always about the bottom line, but would you say trust is an issue? People don’t have trust in our medical system.
Dr. Pizzorno: I think trust in the medical system has decreased quite a lot. You may have heard about this project I’ve been working on in Flint, Michigan, where we’re looking at low-income minorities and provide them natural medicine services. One of my biggest surprises was how alienated they are from conventional medicine. They’re tired of toxic drugs and feel like they’re being experimented on.
IMCJ: You would think there’s something that could be done. Is there’s nothing that the government or a third-party can do?
Dr. Pizzorno: It seems that way because so much of the government now is to support their vested interest. We know about corporate takeover of government agencies. It seems like a real phenomenon.
IMCJ: Does it appear that the mental health really is as bad as we hear it is.
Dr. Pizzorno: Yes. It has been getting worse and worse. I am extremely concerned for children as their level of health has been deteriorating for the past half century.
Both physical and mental health has worsened, and it doesn’t get any better when they become adults.
IMCJ: Is there one type of mental illness for children and another for adults?
Dr. Pizzorno: There are different diagnostic terms, but I think they all reflect similar neurological damage and dysfunction. ASD (Autism Spectrum Disorder) is a condition which once was rare is now surprisingly common. We have people with minimal symptomatology versus those with a lot of symptomology. The bottom line is, we have a lot more, and when people start getting on the ASD spectrum, their ability to make decisions about their life, interact with other people and establish loving relationships is all damaged.
IMCJ: Free healthcare is probably something we’ll never see in our lifetime.
Dr. Pizzorno: Well, we’ve seen free healthcare in Canada and United Kingdom, and you see what the benefits are. You also see what the limits are. From my work in Canada where I designed and help implement a sophisticated corporate wellness program. I sawa man who had a hot liver that came back with elevated liver enzymes. I was really concerned that he had some kind of severe liver disease process going on. I tried to refer him to a hepatologist and there was a three-month waitlist. So yes, they have free healthcare, but the way they have free healthcare is basically by rationing and decreasing availability for people with expensive diseases.
IMCJ: Looking at Obamacare (Affordable Care Act), it has pluses and minuses.
Dr. Pizzorno: I look at Obamacare as rearranging the chairs on the Titanic. All they’re doing is changing who’s paying for things to make it easier for people to get access to care who may not have the funds for. But it didn’t deal with foundational problems in the healthcare system. Obamacare initially had some interesting components to it which I was supportive of, but most ended up being lost as it went through the political process. What does it mean? If you look at the original ideas it was a lot about health promotion, and addressing the reasons people are sick. What ended up happening was it was just lost in the whole process.
IMCJ: Is there a way to modernize the U.S. Healthcare system?
Dr. Pizzorno: For sure. I think what has to happen is we have to change our priorities. If you look at an optimal healthcare system it’s composed of four parts.
Number one is public health. Public health should be more than just contagion control. Public health should engage in teaching farmers how to increase the nutritional content of their crops and decrease the amount of chemical and metal contamination of the crops. In other words, really broad health promoting perspective on public health. By far we should be spending way more on public health than we currently do.
Second, we need a new kind of primary care that is basically what I’ve been promoting naturopathic medicine needs to be. My vision is doctors provide the standard diagnosis and treatment in a primary care setting, but also bringing in health promotion. The time when patients are most receptive to health messages is with their primary care doctor.
The primary care doctor needs to go from the limitation of 10 minutes spent with a patient which basically only allows diagnose the disease and determine the best drug. We need to spend more time in that primary care so you can help the patient understand why they got sick and how to not only avoid being sick in the future, but actively promote their health. So, much more emphasis needed on primary care that’s curative to help them want it in nature.
Next, we still need advanced care for when an organ or function of a person’s body is broken down and that’s where most conventional functions right now, and where all you have is advanced disease. That’s fine for now and let’s keep on doing it. But let’s spend less money on that and more money on prevention for people who need it.
The fourth area, and I didn’t used to say it gently, but I now realize I have to. We have to help people get better engaged and take their responsibility for their health.
We have to reverse te effort by the commercial medicine community to make people believe they are victims of disease rather than masters of their own health. Now, they’ve changed recently, but in the past the message was, “It doesn’t matter what you do. Come to us for drugs and we’ll fix it.” For a while that seemed to work because the symptoms went away. But the bottom line is now people are trained to believe that they can be sedentary, overweight, eat all the junk food they want, and just go to the doctor. The doctor will take care of it.
I don’t care how good your natural therapy is if people’s basic lifestyle is super unhealthy. There’s great limits to what you can do. The patient is the fourth part of this the public health, comprehensive primary care, advanced care, and the patient. Those are the four pieces, and if we work on all those we can dramatically change what’s going on in the population.
IMCJ: If you headed up a national health agency today what might the future of healthcare look like?
Dr. Pizzorno: I’d love to. I think we would come to clear grips about the difference between healthcare and disease care. Right now, we have disease care. We need it, don’t get me wrong, but we must have healthcare as well. I would basically create a department whose primary purpose was promoting health of the population and helping those who are responsible for disease care be more supportive of the health promotion side of things and develop a balanced healthcare system.
IMCJ: You said you’d love to. Would the NIH need to approach you?.
Dr. Pizzorno: It would be the President. Presidents Clinton and G.W. Bush previously appointed me to governmental agencies to help them with their thinking. We need to create a new governmental agency that’s just around health. You have a Department of Defense. Let’s have a Department of War. We need a Department of Peace which I guess the State Department is supposed to be doing. We need the Department of Health to match the Department of Disease.
IMCJ: It’s a presidential appointment. So, that’s probably not going happen anytime soon, unfortunately.
Dr. Pizzorno: Congress could create a department and that would be fine.
IMCJ: Still probably not going to happen. Just wishful thinking.
Dr. Pizzorno: True. Remember, you look at the AMA and the pharmaceutical industry and thye are some of the biggest donors to the political process. So, they have a huge influence.
IMCJ: Any final thoughts about the state of our health?
Dr. Pizzorno: The body has tremendous ability to heal. Over the years I’ve looked at a lot of research. I’ve identified articles that actually document the body’s ability to heal. Here’s an example using kidney failure.
We now have an epidemic of kidney failure in the U.S. Typically, we determine if people’s kidneys are functioning properly by using a measure called eGFR. As eGFR goes down kidney function is going down, and it gets bad enough, people have to go on dialysis, and eventually get a kidney transplant.
Kidney function is typically reported on a five-point scale. If it’s down to five, the kidneys are pretty much done and have to be replaced. One study took a goup of patients with Stage 5 kidney failure and EGFR of 12 on average, An eGFR of 12 is really bad. It should be like 80 to 100. Their intervention was to have these patients with kidney failure simply stop taking non-steroidal anti-inflammatory drops, such as aspirin and ibuprofen. Six months later they remeasured the EGFR. It more than doubled to 25 on average! So, just by stopping the damage to the kidneys they regenerated. All our tissues have the ability to regenerate if just given the chance.
What does that mean? It means stopping damage and stopping putting poisons, metals, chemicals and drug poisons into people and replacing them with the needed nutrient required for our organs to function properly. My belief is that most of the disease we suffer today is unnecessary. Only 15% of disease appears to be due to genetics. Let’s start paying attention to the 85% and do something about it, Even some of the 15% which is genetics amenable with smart nutrition.
IMCJ: At the end of the day, what nutrients would you recommend?
Dr. Pizzorno: There are many nutrients to recommend, but more important is to recommend simply eating real food. The foundation of health is to prioritize eating whole foods, organically grown and processed in ways the protect their nutritional status.
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