A 360-Degree Approach
Tracey Dennison shares a patient case study demonstrating how to combine traditional and lifestyle medicine.
Combining multiple evidence-based treatment approaches is crucial for providing optimal treatment outcomes, especially for patients with complex, multifaceted health issues.
Traditional medicine, lifestyle medicine, and complementary therapies each offer unique benefits and, when integrated, can address the diverse needs of patients more effectively than any single approach alone. The integration of these approaches is supported by a growing body of research demonstrating their individual and synergistic benefits. This case study explores the management of a patient with a significant medical and psychological history, highlighting the importance of a comprehensive, integrative treatment plan compiled by appropriately qualified medical professionals and usually involves multi-disciplinary involvement.
The patient is a 69-year-old woman with a complex medical history, including substantial psychological trauma from her formative years and adult life. She is a caregiver to an older child with significant and complex needs. Her anxiety levels are exceptionally high, and she struggles with irritable bowel syndrome (IBS), rheumatoid arthritis, tinnitus, urinary frequency and urgency, poor sleep, dry skin, eczema, increasing allergies, and disordered eating. Socially, she is retired, with her husband managing household decisions and finances. Despite having three children, she has a very limited social circle and lacks confidence. She has no real support network, no daily routine, and does not smoke or drink alcohol. Primary care interventions have included lansoprazole for IBS, paracetamol for pain management, and antianxiety medication. Additionally, she had access to talking therapies in the past but has significant health anxiety, leading to multiple invasive investigations.
The management approach for this patient involved a comprehensive, patient-centred consultation. The aim was to make her feel seen, heard, and validated, holistically addressing her needs through traditional and lifestyle medicine approaches.
Daily routine and sleep hygiene
Creating a daily routine was emphasised to help her feel safe and in control. Research indicates that establishing a consistent daily routine can significantly reduce anxiety and improve overall mental health.1 Additionally, getting exposure to daylight early in the day was recommended to reset her body clock. This is supported by findings that natural light exposure can improve sleep quality and mood by regulating circadian rhythms.2
Diet and nutritional interventions
Dietary modifications included reducing caffeine intake to improve sleep and bladder irritation. An anti-inflammatory diet low in refined sugar and high in anti-inflammatory foods like berries and cherries was also suggested, which can help manage rheumatoid arthritis and other inflammatory conditions.3 Introducing prebiotics and probiotics was recommended to enhance gut health, as these have been shown to alleviate symptoms of IBS and improve overall digestive health.4 Additionally, supplementation with vitamin D and magnesium bis-glycinate at night was advised to support bone health, reduce inflammation, and improve sleep quality.5
Alternative therapies
The potential benefits of acupuncture for pain management and relaxation were discussed, and an accredited practitioner was recommended. Studies have shown that acupuncture can be effective in reducing chronic pain and anxiety.6 Breethe work, a form of guided breathwork therapy, was also suggested for its potential to reduce stress and anxiety.7
Hormone Replacement Therapy and psychological support
Body Identical hormone replacement therapy (HRT) was considered as an option to address systemic and vaginal health issues, especially given the patient’s age and symptoms. The benefits and risks were clearly discussed, particularly with this being an older patient. Post-menopause, HRT can still help manage symptoms related to hormones, including anxiety and sleep disturbances.8
Referral to clinical psychology was made to provide ongoing mental health support, which is crucial for managing this lady’s significant health anxiety and likely post-traumatic stress disorder.
Nature and social support
Spending time in nature was encouraged, as it has been proven to reduce stress and improve mental well-being.9 Building this into a regular routine was also encouraged to help provide some daily structure and routine.
Simple coping strategies for intense stress were provided, and efforts to establish a network of support and social connections were initiated. Building social connections is vital for mental health, providing emotional support and a sense of belonging.10
Discussion
The integrative approach used in managing this patient highlights the importance of combining traditional medicine with lifestyle and alternative therapies. Each intervention was based on credible research supporting its efficacy and safety.
The recommendation for a daily routine and early daylight exposure is grounded in solid evidence of their benefits for mental health and sleep regulation. For instance, Fisher et al. (2018)1 found that establishing daily routines can significantly reduce anxiety and improve mental health outcomes.
Additionally, Cseisler & Gooley (2007)2 provide substantial evidence on how daylight exposure impacts circadian rhythms and overall sleep quality.
Dietary changes and supplements, such as reducing caffeine intake, following an anti-inflammatory diet, and using probiotics, are also supported by robust research. Studies by Sköldstam et al. (2003)3 and Rondanelli et al. (2017)4 demonstrate the benefits of these dietary interventions in reducing inflammation and improving gut health, respectively. The suggestion to supplement with vitamin D and magnesium is backed by research showing their role in reducing inflammation and improving sleep quality.5,11
Alternative therapies like acupuncture and breathwork have demonstrated effectiveness in clinical studies. Vickers et al. (2018)6 provide evidence that acupuncture can significantly reduce chronic pain and anxiety. Similarly, Jerath et al. (2006)7 support the benefits of breathwork in reducing stress and promoting relaxation.
Evidence supports the use of HRT and referral to clinical psychology, indicating their effectiveness in managing menopause-related symptoms and providing mental health support. The North American Menopause Society (NAMS, 2017)8 highlights the benefits of HRT for managing anxiety and sleep disturbances during menopause.
Finally, the encouragement to spend time in nature and build social connections is grounded in research showing the mental health benefits of these activities. Bratman et al. (2015)9 demonstrate how nature exposure reduces stress, while Holt-Lunstad et al. (2010)10 provide a meta-analytic review of how social relationships impact mortality risk and mental health.
Conclusion
Natural biohacking and lifestyle medicine offer a robust framework for empowering patients to take charge of their health and well-being. By focusing on patient empowerment rather than costly treatment options, healthcare providers can support individuals in making sustainable lifestyle changes. This patient-centred approach gradually introduces credible treatment options, enhancing compliance and long-term benefits.
This case study prioritises a holistic and personalised approach and demonstrates how integrating traditional and lifestyle medicine can lead to significant improvements in patient outcomes. The focus on patient empowerment, credible research-backed interventions, and sustainable lifestyle changes provides a model for managing complex, multifaceted health issues effectively.
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References
1. Fisher, E. B., Thorpe, C. T., DeVellis, B. M., & DeVellis, R. F. (2018). Healthy coping, negative emotions, and diabetes management: A systematic review and appraisal. The Diabetes Educator, 33(6), 10801103.
2. Cseisler, C. A., & Gooley, J. J. (2007). Sleep and circadian rhythms in humans. Cold Spring Harbor Symposia on Quantitative Biology, 72, 579597.
3. Sköldstam, L., Hagfors, L., & Johansson, G. (2003). An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis. Annals of the Rheumatic Diseases, 62(3), 208214.
4. Rondanelli, M., Giacosa, A., Faliva, M. A., Perna, S., Algieri, F., & Peroni, G. (2017). Review on microbiota and effectiveness of probiotics use in older. Current Pharmaceutical Biotechnology, 18(9), 704713.
5. Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266281.
6. Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., ... & Linde, K. (2018). Acupuncture for chronic pain: update of an individual patient data meta-analysis. The Journal of Pain, 19(5), 455474.
7. Jerath, R., Edry, J. W., Barnes, V. A., & Jerath, V. (2006). Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical Hypotheses, 67(3), 566571.
8. NAMS (North American Menopause Society). (2017). The 2017 hormone therapy position statement of The North American Menopause Society. Menopause, 24(7), 728753.
9. Bratman, G. N., Hamilton, J. P., Hahn, K. S., Daily, G. C., & Gross, J. J. (2015). Nature experience reduces rumination and subgenual prefrontal cortex activation. Proceedings of the National Academy of Sciences, 112(28), 85678572. 10. Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7(7), e1000316.
11. Wienecke, T., & Nordin, C. (2016). Magnesium status and migraine. Cephalalgia, 36(5), 499507.