Editor’s Note: I had a great experience of being a patient of Dr. Myrto Ashe, M.D., M.P.H. who rightfully calls herself an unconventional medicine doctor. Dr. Myrto Ashe spends enough time with a patient to learn what lies beneath the symptoms, in order to learn how to cure the underlying problems, as opposed to simply treating the symptoms. Her care and attention also inform her how to prevent other potential health problems from happening. I gained so much appreciation for her unconventional medicine practice I asked Dr. Ashe to do this interview so my blog readers can benefit from her wisdom.
Dr. Myrto Ashe, your website’s name is “Unconventional Medicine;” what do you mean by unconventional medicine?
When I began my private practice, it was clear to me that the first thing patients need to know is that I do not follow the agreements, or “conventions” that most other doctors agree to follow. I am very open and clear about how I come to my conclusions, how strong the evidence is behind the treatments I am proposing, and why I think at any time, we should, or should not, deviate from what other doctors would do. For example, if you have high blood pressure, I will suggest a number of approaches that I believe the research supports, but that have not been the standard approaches in the United States. I will explain why I think they are preferable, and you get to decide what you would like to do.
My entire practice is unconventional. I practice out of a low-key simple office, with no office staff. We communicate directly about setting up appointments, about getting lab results, about any problems you encounter. Visits are longer than they would be at a regular doctor’s office. I spend more time explaining things than most doctors do. My goal is to give you the tools so you can be in charge of your health. I use the name “unconventional medicine” to make sure people aren’t taken aback when they show up and find that nothing is as they are accustomed to. This ensures I get patients who know they don’t want artificial chemical medications or surgery, and who are willing to put in the extra effort to change their lifestyle.
What are the advantages of unconventional medicine over conventional medicine?
Conventional medicine is best suited to short-term problems. If you are in a car crash, you will be most grateful for the incredible advances and skills that will save your life, or some important part of your body. However, what we are dealing with most of the time is problems that nag at us for years, or that will eventually lead to further problems. The question is whether a problem you are having is happening in an isolated manner (meaning, that is the only problem) or if it’s just the tip of the iceberg. For example, if you just had an accident with a sharp knife, the rest of you is basically fine. Best go see a surgeon or ER doc and have that fixed and nothing else needs to happen. But if you have high blood pressure, giving you a pill to bring it down is very short sighted. You need to figure out why the pressure is up. The body is trying to make up for something. The best analogy is the light on the dashboard of your car telling you something is wrong. Covering up this light doesn’t make the problem go away.
Another problem conventional medicine has is the involvement of pharmaceutical companies. They control much of medical education and 80% or more of scientific research. They don’t have any incentives to encourage alternatives to pills. As a result, Americans are the most heavily medicated people on the planet, but not the healthiest, by far. In fact 250,000 deaths a year are caused by avoidable medical interventions. This makes medical errors the 3rd leading cause of death. You get a pill for your blood pressure, one for depression, one for your back pain and one to help you sleep. Then it is found that your cholesterol and maybe your sugar are a bit high and you are told that you will prevent future problems with two new pills. But there is no research on whether it is helpful or harmful to use a preventative pill in cases where so many other pills are already on board. Eventually, there is an interaction between the pills and something goes awry, especially as people get older.
Are there any shortcomings to unconventional medicine?
Yes, of course. The biggest shortcoming is that you will have to do more than pop pills and it will not be as easy. There are diet changes and changes in activity level, and you will need the willingness to explore activities that bring down the body’s stress level. The flip side is that you will also feel more vibrant, which isn’t usually the case with pills. You will also need to be open to the idea that your body has an innate wisdom, and that it may be possible to tap into that and trust that the body may find its way to health with proper support. Some people think of their body as having basically betrayed them, and the idea that they could trust it for anything is too difficult to consider.
Another drawback is that we don’t have the scientific backing. Some of what we recommend is based on logical deductions from basic science or animal studies. For example we know that high blood sugar levels over time make Alzheimer’s disease more likely, and work against mental and immune system health, so we recommend a fairly aggressive approach to lowering carbohydrates in the diet. But we don’t know if this raises the risk of some strange other illness, because a 60 year study of people eating low carb hasn’t been done, looking at all outcomes and disabilities. However, that is true of much of conventional medicine as well—50% of antibiotics are prescribed for no good reason for example—it’s not as evidence-based as it would like to be.
Describe the process of how you approach treating illnesses in your unconventional medicine practice.
This question makes me feel like writing a book!
My first step is to listen to the whole story. I ask my patient to review their whole life story with a special emphasis on how their health was at any given age, and what was going on in their lives that was significant. The first order of business is to come to understand what healing is possible.
The second step is to make sure I don’t have to rule out something dangerous. I do not hesitate to refer to my conventional colleagues. It’s not common, because people usually come to me after seeing a number of specialists, but I remember one little boy who seemed to me to have a genetic abnormality. It may be that supplements and lifestyle change would help, but honestly first he needed a diagnosis.
The third step is to make sure the basic building blocks are in place. That is complicated. You have to provide them (adequate protein, the right fats, fish oil, vitamin D, probiotics, etc…) but you also have to make sure the body is absorbing them. Bodies need to be in a state of relaxation most of the time in order to do all the housekeeping, building, adjusting functions they know how to do. We can’t micromanage everything because we don’t know how the body does everything it does. We need as much help as possible from the body’s finely tuned innate mechanisms.
The history I got in the first step allows me to make educated guesses as to where to focus my efforts. What body system (immune, neurological, gut absorption, protein and mitochondrial damage) is involved as the underlying cause? This allows me to target the intervention, because there is no ideal diet or ideal exercise for all, and because we can’t do it all—we have to prioritize.
I work in layers. I don’t like to do unnecessary tests. I like to do them in sequence according to the one I would address first. So I don’t like to check estrogen levels until I know nutrition, stress and exercise are under control. I don’t like to treat symptoms if I have an underlying cause I can address. There are exceptions that require shortcuts, for example, people need to sleep and so then we use herbs or natural substances that have the least potential risk for side effects.
I know that Genova Diagnostics’ NutrEval test is a part of your unconventional medicine practice. What is it and why is it important to take the test?
The NutrEval is an attempt to describe how well-supplied the body is in vitamins, fats, minerals, amino acids, and what type of stress it might be under, from the point of view of toxins and excessive immune activation. The problem we face is that measuring vitamin levels just doesn’t work—the vitamins act inside cells and so the blood levels often aren’t relevant. Also some people need more vitamins than others because of genetic reasons, or because of toxins, stress or inflammation. However, there is no research on the NutrEval itself. There is no experiment where they took a hundred people, did the test, and described what happened. There is only the basic science that tells us the body substances measured do reflect vitamin adequacy, or function of the system, and there are many anecdotal reports of patients doing much better soon after receiving the vitamins recommended by the test.
I like to use this test when I feel that the immune system might be missing something, and I can’t guess what from the history. It’s also a great test to do to get a sense of whether there is a good fit between your diet and what your body needs at the moment.
What are the most important NutrEval test parameters to look at?
The NutrEval has several sections. I helps me determine whether digestion is adequate, whether fish and chicken in particular are well-digested, whether the right mix of beneficial bacteria are in the gut, and whether there are any harmful microbes in the gut. Then it goes on to calculate possible amino acid, vitamin and mineral deficiencies. There is a section that estimates how well a patient dismantles certain classes of toxins, whether it looks like cell membranes or DNA are being damaged and not repaired efficiently, and a section that gives a snapshot of possible heavy metal exposure, such as lead, mercury, cadmium, and so on. Finally, there is a detailed section on fatty acids, including omega 3 and omega 6, and saturated fats. Studies are just beginning to catch up with this, for example it has recently been shown that elderly folks with higher levels of certain omega 3 fatty acids have better cognitive skills, maybe 1-2 years “younger” than their low omega3 peers. So this information is relevant, and optimizing these levels is likely desirable.
Can the NutrEval test help prevent cancer?
It would be most fair to say that we don’t know. The NutrEval does measure 8-hydroxy-deoxyguanosine (8-OHDG). Research shows that patients with high levels of 8-OHDG have higher rates of cancer, because it is a marker for DNA damage. However, there is no study where they lowered it and compared it to placebo and found a lower rate of cancer. On the other hand, lowering 8-OHDG is done by eating a diet high in fruits and vegetables, and if needed, taking more of certain vitamins than you would otherwise. We have pretty good research showing the protective effect of certain vegetables and vitamin C on cancer in persons with radiation exposure, which is relevant here precisely because DNA damage is the type of problem you see with radiation exposure. So it’s very likely that checking and fixing 8-OHDG through diet and lifestyle would benefit the patient. Of course everyone should follow a healthy lifestyle, but this is a way to focus your efforts.
How did you become so knowledgeable and skillful at interpreting the NutrEval test results?
I have been getting NutrEvals (and there are other tests like the ION panel) for 2 years now. California physicians are not allowed to overcharge for tests, so the only reason to do the test is to see if a patient’s nutrient profile can be improved. In the beginning, I reviewed each test with the staff at the laboratory. The first one took me 45 minutes to review. Then I started seeing some of the same patterns again and again and within about a year, I got to where I only needed the staff for one or two questions per test. Now I analyze most of them on my own, unless there is a pattern I haven’t seen before. The results on the test dovetail with my independent reading: for example there was a recent article in the New England Journal of Medicine explaining that the B12 vitamin level was useless and we should be using the methylmalonic acid level instead. This is something that has been a part of the NutrEval for years. So it’s reassuring when unconventional medicine gets the backup from conventional medicine. Same with the omega 3 example I gave earlier.
What are the top three things people should do stay healthy?
In that order:
- get a handle on negative thoughts and ruminating thoughts (this can involve meditation, yoga, or other mind-body techniques)
- exercise more (an hour of moderate activity daily would be good)
- eat a diet of very simple foods as close as possible to their natural state, and focus this diet on plants (Michael Pollan said it best: “eat food, not too much, mostly plants”)
And a final piece, if I may: Look at your environment: pay attention to toxins; support efforts to clean up the air and water around you.
How can you be contacted? Do you do work with patients long-distance?
It is best to send me email at [email protected], or leave a message at 415-663-6825. The first visit must be in person, but I am happy to do most follow up visits on the phone, unless a rash or other obviously visual problem comes up. Telephone health advice is regulated by state medical boards.
Editor’s Note: Dr. Ashe is located in Mill Valley, California. She is currently offering a 20% discount off the initial visit until March 31, 2014 to my blog readers. To learn more, visit Dr. Ashe’s website and blog at http://www.unconventionalmedicine.net