Dr. Weil on the development of integrative medicine in modern practice

June 16, 2019

Integrative medicine is the solution to the desperate problems and complications of chronic degenerative disease experienced in the U.S. Conventional medicine is really ineffective when it comes to these issues
We need to elect representatives who are not beholden to the vested interests that want the health care system to go on as it is. Vested interests are profiting greatly from the present system and are blocking the implementation of more effective and less expensive strategies
The 4-7-8 breathing technique Dr. Andrew Weil teaches activates your parasympathetic nervous system, which improves your heart rate variability, improves digestion and blood circulation and lowers high blood pressure
About 50% of 80-year-olds have sarcopenia (loss of muscle mass). One of the key prevention strategies for sarcopenia is to stay active and use your muscles as much as possible. This is also why strength training is so highly recommended for seniors
The University of Arizona is committed to making integrative medicine a top priority. The Andrew Weil Center for Integrative Medicine is getting a building on campus and will open the first integrative medicine primary care clinic there in Tucson in 2020

Dr. Andrew Weil, director of the University of Arizona Center for Integrative Medicine, is one of the true pioneers of this field, having advocated holistic approaches to health for about 50 years.

"I was always interested in science and biology," Weil says, and "I have a lifelong interest in plants … that led me to be a botany major at Harvard as an undergraduate and started me on a career interest in medicinal plants."

Fascinated by mind-body interactions, Weil began studying alternative medicine in college. After graduating medical school, he did a yearlong fellowship with the National Institutes of Health. He also did a fellowship with the Institute of Current World Affairs, which allowed him to travel around Latin America and Africa to collect information on medicinal plants and traditional healing.

"I chased around the world looking for healers and to see what I could learn because I felt that what I had learned in my conventional medical education wasn't going to serve me. I saw the methods do too much harm, and I had learned nothing about keeping people healthy," Weil says.

"The irony is that when I finished traveling and landed back in Tucson, it turned out the person who had most to teach me had been here all along. That was Dr. Robert Fulford. He was a doctor of osteopathic medicine (D.O.). He was then in his 80s and a master of cranial therapy.

He really made me aware of the healing power of nature. I am an enormous fan of osteopathic manipulation and cranial therapy. I recommend them a lot. I hope more D.O.s will go back to their roots and again practice manipulation ...

After I finished my internship, I took a course at Columbia University on medical hypnosis — one of the most interesting courses I ever took. As a result of that, I also make frequent referrals to hypnotherapists. I have, again and again, seen how changes in the mental realm initiate healing and affect the physical body.

To me, that's one of the great limitations of the dominant scientific and medical paradigm, which only looks at the physical as being real and believes that changes in the physical system must have physical causes to be physical. Nonphysical causation of physical events is not allowed for. Integrative medicine philosophy challenges that materialistic paradigm."

The emergence of integrative medicine

It wasn't until the 1990s that medical institutions began opening up to Weil's methods. "I had a large following in the general public, but none of my medical colleagues paid any attention to me," he says. In the '90s, however, health care economics began faltering, forcing institutions to start listening to what patients really wanted.

At a fundamental level, integrative medicine is the solution to the desperate problems and complications of chronic degenerative disease experienced in the U.S. Conventional medicine is really ineffective when it comes to these issues. As for the best way to help conventional physicians embrace these strategies, Weil says:

"My focus has been on training physicians and allied health professionals through the University of Arizona Center for Integrative Medicine. We have a two-year intensive fellowship. We now have 1,800 graduates: highly physicians, nurse practitioners and physicians' assistants in practice in all states and in a number of other countries.

Many of them are now training other people. We also have a curriculum in integrative medicine in residency training that's now been adopted by 70-some residency programs around the country (as well as in Canada, Germany and Taiwan)."

While 1,800 doctors are a drop in the bucket — a fraction of a percent of the 1.1 million physicians in the U.S.1 — they are important change agents.

"I think for things to change, there has to be a grassroots sociopolitical movement in this country, in which enough people get angry enough about the way things are," Weil says. He hopes the growing numbers of health professionals trained in integrative medicine will catalyze that movement.

We also need to elect representatives who are not beholden to the vested interests that want the system to go on as it is. Those interests are blocking the implementation of more effective and less expensive strategies.

"We may have to have a total crash of the health care system for things to change," Weil says. "To every graduating class of our fellows, I say, 'You are the ones who could start this movement in the country.' Doctors are victimized by the current system. They should be marching in the streets, demanding change.

As dysfunctional as our health care system is, it's generating rivers of money. That money is flowing into very few pockets — the pockets of Big Pharma, the manufacturers of medical devices and the big insurers. Those vested interests have total control of our representatives …

I think doctors today are so unhappy. I hear many, many doctors say they wish they hadn't gone into medicine. They'd never let a son or daughter of theirs go into medicine. I never heard anything like that when I was in college. Medicine looked like a very desirable profession. You could be your own boss. You were highly regarded in society.

All that has changed. Throughout history, much of the satisfaction of practicing medicine derived from the therapeutic connection with the patient, the getting to know someone. All that has evaporated in this era of for-profit, corporatized medicine. The time allowed for medical visits gets shorter and shorter.

The main obstacle is that our priorities of reimbursement are totally backward. We happily pay for drugs, for invasive procedures, for diagnostic testing. We don't pay health professionals to sit with patients and talk to them about diet or teach them breathing exercises. That has to change.

Of course, we also need to have data to show to the people who pay for health care that integrative approaches using lifestyle modification and natural therapies save money and produce outcomes that are equal to or better than those of conventional medicine."

Breathing basics

One of Weil's health strategies is a simple breathing technique called "The 4-7-8 Breath." "I teach that whenever I get the chance. I've done it with all my patients. I teach it to all our fellows. I do it with friends. I teach to all groups I speak to," Weil says.

"It's breathing in through your nose to a count of 4, holding your breath for a count of 7, blowing air out through your mouth to a count of 8, and doing this for four breath cycles at least twice day day. You have to practice it regularly. It is the master key to changing the activity of the involuntary nervous system," he explains.

"Of all the remedies that I've given to patients over the years, the one that I've gotten the most positive feedback about is that simple technique. It costs nothing, uses no equipment, takes very little time. Medical doctors don't take it seriously because they don't believe that something so simple — something that does not involve a drug or device — can change anything in the body. For that reason, little research has been done on breath work.

I do the 4-7-8 breath at least twice a day — when I wake up and when I go to sleep — and any time during the day that I feel that I want to focus and relax. (I now do eight breath cycles at a time and don't recommend any more than that.) One result that I've seen in myself: I have a very low heart rate. It's usually in the low 40s, sometimes in the high-30s.

I exercise regularly, but I'm not fanatical. I swim and walk every day. But up until maybe 20 years ago, my heart rate was around 70. The only way I can explain the change is that it is a result of doing that breathing exercise regularly. It has increased my vagal tone, slowed my heart rate and kept my hands very warm most of the time. It's the power of the relaxation response — one of the great rewards of doing this breathing practice."

Aside from activating your parasympathetic nervous system, which increases your heart rate variability, proper breathing will help improve your digestion and blood circulation and lower high blood pressure.

Maintaining cognitive and physical health into your senior years

At 77, Weil is also a testament to the cognitive benefits of this and other holistic techniques. His mental acuity for someone in their late 70s is truly remarkable, and doesn't seem to have changed since his youth. When asked what he attributes his general health to, he says:

"I get good rest and sleep. I use supplements wisely. I'm a great believer in the power of mushrooms. I take a number of mushroom products that I think are helpful both mentally and physically. I eat a lot of fermented foods. You know there's increasing research on the connection between the microbiome and mental-emotional well-being.

I think that's another strategy. And I drink matcha green tea every day. (I am so much a fan of it that I created a company — Matcha Kari — and got the URL matcha.com to bring high-quality matcha from Uji, Japan, to people in this country.

I spend time with people who are active and happy and positive and I think that's a great strategy as well. I have two companion animals, two wonderful dogs that I spend a lot of time with. I attribute a lot of my well-being to living with them as well."

Among Weil's favorite medicinal mushrooms are turkey tail and lion's mane. Turkey tail has a number of cancer-protective effects, both preventively and therapeutically, while lion's mane contains a unique nerve-growth factor. "I recommend it to people with neuropathy," Weil says. There's also evidence suggesting lion's mane can help improve cognitive function.

True food kitchen

Last year, I had the opportunity to try out the True Food Kitchen while at the Paleo f(x)™ conference in Austin, Texas — a restaurant chain Weil conceptualized. He explains:

"I'm a very good home cook. I'm not a chef. But over the years, many people have said, 'You ought to open a restaurant.' I was never tempted to do that because I know nothing about the restaurant business, and it looked like a very tough business.

But about 11 years ago, a mutual friend introduced me to a very successful restaurateur in Arizona, Sam Fox. I proposed the concept of a restaurant that would serve wonderful, delicious food that was also healthy. His immediate reaction was, "Health food doesn't sell."

I think he thought I meant tofu and sprouts. He regarded me as a hippie and didn't see any possibilities for a collaboration. I invited him and his wife to my home. I cooked a meal for them. They liked the food. His wheels began to turn, and he said he would give it a try, but he was very skeptical that the concept would succeed.

We opened our first True Food Kitchen in Phoenix 11 years ago. It was a success right out of the gate. There are now 29 of them around the country. People love the food. We still don't have any real competition. The menu is based on my anti-inflammatory diet, with something for everyone there.

You can go with a mixed group. There are meat entrees — although not many of them — wonderful produce and fish. Gluten-free people can get what they want, people who are vegans, paleo or keto can find what they want there. It's been a great delight to see people liking the kinds of food I've enjoyed most of my life."

We certainly need more restaurants like that, because eating too much processed food is one of the key challenges most people have. While you may not think of restaurant food as processed, a vast majority of it is.

Staying active is a key component of longevity and health

About 50% of 80-year-olds experience sarcopenia, loss of muscle mass. As noted by Weil, one of the key prevention strategies for sarcopenia is to stay active and use your muscles as much as possible. This is also why strength training is so highly recommended for seniors.

"I use my muscles a lot," Weil says. "I am careful in what I do, but I go up and down stairs a lot when I get the chance. I lift things. I don't feel that I've lost muscle strength. I certainly have more aches and pains than I did when I was younger, but I think my musculoskeletal system is in good shape …"

"It's important to pay attention to how your body changes and how it reacts to different things … In my 20s, I ran for a time — until I got signals from my knees that they didn't like that. I shifted to cycling and did that for a long time. And then I got into swimming, which agrees with me very much. I think it's good to be flexible and open to change …"

Integrative medicine is the answer to many growing problems

Like me, Weil sees integrative medicine as the way of the future. "I've always said that one day we'll be able to drop the word 'integrative' and it'll be just 'good medicine,'" he says. He believes this transition is inevitable, because the forces that are taking down our health care system continue to build.

This includes a growing population of seniors, uncontainable health care costs due to our dependence on expensive technologies and drugs, and growing epidemics of lifestyle-related disease that conventional medicine cannot successfully manage.

"This is happening all over the world, but it's most advanced in the U.S.," he says. "Our health care system is farther over the cliff. At the same time that we are paying more for health care than any other people in the world — now 18% of our GDP — we have worse health outcomes than any other developed nation. The World Health Organization ranks us 38th, on par with Serbia. Something is very wrong with that picture. It's unsustainable."

On cannabis

One positive change is the growing acceptance of medicinal marijuana and hemp, the latter of which was legalized in the 2018 Farm Bill. While Weil no longer uses cannabis, he recounts his personal history with the plant during his 30s. He also conducted the first ever double-blind human experiments with cannabis, which were published in the journal Science in 1968.

"We've been very stupid in our relationship with that plant," he says. "Cannabis sativa — the word 'sativa' means useful — is amazingly useful. It gives us a very high-quality oil and an edible seed, a medicine, an excellent fiber and an intoxicant. That's a lot of ways for one plant to serve us.

We have let a multibillion-dollar industry in hemp textiles slip away to China, a multimillion-dollar industry in edible hemp products go to Canada. We have rejected cannabis as medicine for a long time. I'm very happy to see this change.

I regard cannabis as the plant world's equivalent of the dog. Dogs long ago decided to co-evolve with us. Cannabis has done the same thing. We can't unravel the ancient history of cannabis, because as far back as we can look, it's always been associated with human settlements and human activity.

It wants to do nothing other than to serve us. It lets us manipulate its genome. It just wants to help us and we have turned it away. It's nice to see that change."

Psychedelics may have a place in medicine

Weil also believes there's a place for psychedelics, such as magic mushrooms. "The great magic and potential of psychedelics is that they can show you possibilities that you otherwise would not have believed," he says. However, once you've touched on these new possibilities, he says you need to find other, nondrug ways to re-experience or maintain them.

"If you try to use the drugs as the sole method of having them, they fail you," he warns. "The example I have written and talked about [is] when I was about 28, I wanted to learn to practice hatha yoga. I worked with a number of postures.

The one I had the most difficulty with was the plow — where you lie on your back and try to touch your toes on the floor behind your head. I worked at this for a long time and I got my toes to within a foot of the floor but no further, because I would have excruciating pain in my neck. No matter how I persisted, I couldn't make further progress.

One spring day, I took a dose of LSD with friends in a beautiful outdoor setting. I felt terrific. My body was completely elastic and flexible, and I thought I ought to try that yoga pose. I lay down, got my feet over my head and lowered them. I thought I had about a foot to go and they touched the ground. I couldn't believe it. I raised and lowered them. It was a source of such delight.

The next day I tried to do it and I got my toes within a foot of the floor and had a horrible pain in my neck. But now there was a difference. I had seen that it was possible. I was motivated to keep at it and, in a few weeks, I was able to do it. If I had not had that experience, I don't think I would have kept up the practice. To me, that's a model of how these drugs work. They can show you possibilities.

I think they have tremendous potential in medicine. Everyone looks at their use in psychotherapy, and that's fine, but I think they have a tremendous potential to change how people experience their bodies. For people who have chronic diseases, a structured psychedelic session can show them that it's possible to be without pain or other symptoms. And that can motivate them to figure out how to maintain the improvement in other ways."

More information

While Weil says he's done writing books, he's in the process of writing a collection of stories from his life. The University of Arizona Center for Integrative Medicine in Tucson, which he still heads up, is also entering a new phase of growth.

"The university has made a solid commitment to make integrative medicine a top priority," he says. We will get a dedicated building on campus and will open the first integrative medicine primary care clinic in Tucson early next year.

You can find more information about this on the Andrew Weil Center for Integrative Medicine website. There, you can also sign up for online courses to explore topics such as nutrition, integrative pain management, cardiovascular health management and more. There's also a research sectionyou can peruse to learn more about the benefits of integrative medicine.

"We think we have a model that is replicable, sustainable, profitable that can be eventually replicated throughout the health care system here and elsewhere. We're expanding our teaching programs. We have a very strong research initiative as well.

This is all very exciting — something I've waited for, for a long time … I think the future is going to be very bright for our field. Medicine doesn't change as a result of intellectual argument. It changes as a result of economic necessity. And time is on our side.

Our health care system is in deep, deep trouble. The wisdom of what [Dr. Mercola] and I have been advocating for so long will become more and more apparent as the health care crisis deepens."

Sunday, June 16, 2019